Narayana
Super Speciality Hospital, Gurugram
Unit of Narayan Health
Schedule of Charges Jan 2021
NSH, Gurugam Schedule of Charges (Effective from 1st Jan 2021) Ver2.0 16 March 2021 Schedule of Charges is effective from 1st Jan 2021 till the next revision, any further addition / modification required will be done as on addendum/ amendments till the next revision.
DISCLAIMER
All the efforts have been made to ensure that there are no inconsistencies or typographical error in the schedule. Nevertheless if any error is noted, it may please be brought to the notice of the billing in charge.
NSH, Gurugam Schedule of Charges (Effective from 1st Jan 2021) Ver2.0 16 March 2021 OPD Charges 1. Hospital Registration charge Rs. 110/-
2. OPD consultation a. All consultations are valid for 7 days (counted from the day of billing) (Up to a maximum of 1 visit to the same consultant.) b. Consultation Charges for all Specialties Services is Rs. 950/-
IN PATIENT DEPARTMENT (IPD) CONSULTATION
SERVICE_NAME G Ward Semi Pvt Private Suite Dlx Suite CCA/ICU CONSULTATION – IP 1100 1400 1700 1900 2100 1400 CROSS CONSULTATION – IP 1100 1400 1700 1900 2100 1400 CONSULTATION – PHYSIOTHERAPY 700 900 1000 1200 1300 900 CONSULTATION- DIETITIAN 450 450 450 450 450 450
IPD CONSULTATION FACILITY IS AVAILABLE ONLY FOR ADMITTED PATIENTS. CROSS CONSULTATION OF OTHER SPECIALIST SHALL BE AS PER EXISTING SCHEDULE OF CHARGES. ROOM CHARGES
Bed Type G Ward Semi Pvt Private Suite Dlx Suite CCA/ICU BED CHARGES – WARD 4200 6300 9500 13000 16500 14000 BED CHARGES - DAY CARE 3200 BED CHARGES - DAY CARE - UPTO 3 HOURS 1200 BED CHARGES - DAY CARE - UPTO 6 HOURS 1600 BED CHARGES - DAY CARE - UPTO 12 HOURS 2800
NSH, Gurugam Schedule of Charges (Effective from 1st Jan 2021) Ver2.0 16 March 2021 BILLING GUIDELINES
BED CHARGES Charges shall be levied as per rates applicable. The billing starts from the time of admission. Procedures, Surgeries, Packages & Doctor Visit, etc. shall be charged according to the respective room category opted for as mentioned. A stay beyond 8 hrs shall attract full day room rent. 24 hrs billing cycle on room rent shall be applicable
BED TRANSFER In the event of a bed transfer during the course of treatment, the higher category bed charges shall be applicable from the day of transfer. Overnight stay charged as per higher room category.
ADMISSION DIRECTLY INTO CRITICAL CARE
In case patient is admitted to Critical Care bed directly, the charges for procedure/surgeries shall be as per the charges applicable to the semi-private room.
CONSULTATION
One follow-up OPD/IPD consultation would be 100% discount within 7 days of a surgical/Medical case. For all procedures, surgeries, diagnostic services and all other services rendered while the patient is in the wards, billing is always done at the current bed category charges. Only one consultation of operating surgeon should be charge on the day of surgery. If the patient admitted after 12 PM, only one visit to be charged for primary consultant.
BILLING OF OT & ANAESTHESIA SERVICES PROCEDURE / SURGERY CHARGES
The charges for any Procedure/Surgery shall be according to the Schedule of Charges. OPD/IPD Procedures against surgeries/ procedures/operations is Surgeon fees only. Anesthesia charges (40%), OT charges (100%) are additional & Assistant surgeon charges (35%) if applicable. Medicines/ consumables/investigations are billed extra. For all packages/procedures/surgery/operations, the medicines/consumables/implants are charged extra separately
NSH, Gurugram Schedule of Charges (Effective from 1st Jan 2021) Ver2.0 16 March 2021 Billing Guidelines for OT 1. Two Surgeries/ Procedures in single sitting, following billing policy shall be applicable:-
a. Higher value surgery shall be considered as principal surgery & shall be charged 100% of procedure Charges/ package charges b. Subsequent surgery with Lower value shall be considered as minor surgery. c. Standard inclusions shall remain as per principal surgery. d. Shall be subject to differential pricing as per room category. POLICY FOR MULTIPLE-SURGERY BILLING (same sitting):
(A) For surgeries billed as standalone services (open-billing):
The following is the policy for billing when more than one surgical service is rendered to a patient in the same sitting:
SINGLE INCISION MULTIPLE INCISION SINGLE DEPARTMENT S1 – to be billed at 100% of the rack rate S1 – to be billed at 100% of the rack rate S2 – to be billed at 50% of the rack rate S2 – to be billed at 100% of the rack rate
MULTIPLE DEPARTMENTS S1 – to be billed at 100% of the rack rate S1 – to be billed at 100% of the rack rate
S2 – to be billed at 100% of the rack rate S2 – to be billed at 100% of the rack rate
(B) For services billed as packages: The following is the policy for billing when more than one packages service is rendered to a patient in the same sitting: SINGLE INCISION MULTIPLE INCISION SINGLE DEPARTMENT S1 – to be billed at 100% of the rack rate S1 – to be billed at 100% of the rack rate
S2 – to be billed at 100% of the rack rate S2 – to be billed at 100% of the rack rate MULTIPLE DEPARTMENTS S1 – to be billed at 100% of the rack rate S1 – to be billed at 100% of the rack rate
S2 – to be billed at 100% of the rack rate S2 – to be billed at 100% of the rack rate
NSH, Gurugram Schedule of Charges (Effective from 1st Jan 2021) Ver2.0 16 March 2021 Billing Guidelines for Packages
Differential charges for procedure, packages, consultant visit apply for different categories of room.
The packages mentioned are for specified number of days only. Details are mentioned below.
CARDIOLOGY PACKAGES INCLUSIONS /EXCLUSIONS: - All implants like Coil, Valve, Devices, etc are not included in package & will be charged as per applicable hospital tariff. CAG/PAG/EPS/RFA packages will be one day & all other procedures are up-to 3 days. Routine cath-lab Medicines, Consumables & investigation are include in package, Implants are not included in the package and will be charged separately. Any stay beyond the above package days would be chargeable. Blood Processing Charge would be charged extra. Acute cardiac incident patients admitted through emergency and undergo cath intervention within 4 hours of admission will be charged for primary PTCA
CARDIAC SURGERY PACKAGES INCLUSIONS /EXCLUSIONS:- Cost of any Implants like valve, conduit, Coils, grafts, blood etc. are not included in the package and will be charged at applicable hospital tariff Charges are inclusive of routine Investigation, define bed charges, Operation & routine medicine & consumables charges only. Length of stay for would be 8 days. Package will start one day before surgery. Any stay Beyond the package period would be chargeable.
NSH, Gurugram Schedule of Charges (Effective from 1st Jan 2021) Ver2.0 16 March 2021 ORTHO PACKAGES INCLUSIONS /EXCLUSIONS:- Arthroscopy Package is for 1 day Charges are inclusive of routine Investigation, Bed charges, Operation charges only. Total HIP/Knee Replacement B/L & U/L packages duration is 7 days & 5 days respectively. All Medicines, Consumables & Implants are not included in the package and will be charged separately. Any stay Beyond the package period would be chargeable.
UROLOGY SURGERY PACKAGES INCLUSIONS /EXCLUSIONS:- Charges are inclusive of Bed charges (TURP & PCNL -4 days),( BNI, URS,URS+LITH, TURBT,CLP/PCCL 3 Days),(OIU,TURP,BNI and laser surgery 2 Days)(Renal Transplant 10 Days) , Operation charges only. Any stay beyond the package period would be chargeable on actual. All Medicines, Consumables & Implants are not included in the package and will be charged separately. All other procedures & cross consultations by other doctors charged extra. Pre surgical profile include in package. All implants, prosthesis, etc. charged extra. Biopsy would be charged extra
GENERAL SURGERY PACKAGES INCLUSIONS /EXCLUSIONS:- Charges are inclusive of Bed charges up to 2 Days, Operation charges only. Any stay beyond the package period would be chargeable on actual All other procedures & cross consultations by other doctors charged extra. All Medicines, Consumables & Implants are not included in the package and will be charged separately. Biopsy would be charged extra All implants, prosthesis, etc. charged extra.
NSH, Gurugram Schedule of Charges (Effective from 1st Jan 2021) Ver2.0 16 March 2021 Procedures/Operations/Surgeries inclusions/Exclusions in all departments:-
The tariffs mentioned against surgeries/ procedures/operations is Surgeon fees only. Anesthesia, Anesthesiologist (40%), OT charges (100%) & {Assistant Surgeon (35%) if applicable} are additional. All Medicines, Consumables & Implants are not included in the package and will be charged separately. Surgery charges break-up as below.
Surgeon Fee 100% OT Charged 100% Anesthetist charges 40% Assistant Surgeon fee 35% Cath Lab charges 40%
In instances where tariff has not been mentioned against a particular category of room, then the standard charges will apply. New investigations, procedures & packages may be added at a later date, tariffs for which will be fixed at the sole discretion of the hospital. The tariff list enclosed is subject to revision at the discretion of the hospital.
NSH, Gurugram Schedule of Charges (Effective from 1st Jan 2021) Ver2.0 16 March 2021 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite Administrative SVC000007 ADMISSION 650 650 650 650 650 SVC000004 BED CHARGES - CRITICAL CARE AREA 14000 14000 14000 14000 14000 SVC000005 BED CHARGES - WARD 4200 6300 9500 13000 16500 SVC000001 CONSULTATION - FIRST VISIT 950 SVC000002 CONSULTATION - REVISIT 950 SVC000003 CONSULTATION - FOLLOW UP 0 SVC000006 REGISTRATION 110 SVC000015 MEDICAL CERTIFICATE CHARGES 200 SVC000019 AMBULANCE BASIC LIFE SUPPORT - FIRST 10 KMS 2000 2000 2000 2000 2000 2000 SVC000020 AMBULANCE BASIC LIFE SUPPORT - PER ADDNL KM 30 30 30 30 30 30 SVC000022 AMBULANCE PATIENT TRANSPORT - SERVICE CHARGES 1000 1000 1000 1000 1000 1000 SVC000023 AMBULANCE ADVANCED LIFE SUPPORT - FIRST 10 KMS 2200 2200 2200 2200 2200 2200 SVC000024 AMBULANCE ADVANCED LIFE SUPPORT - PER ADDNL KM 40 40 40 40 40 40 SVC000026 AMBULANCE PATIENT TRANSPORT - NURSE UPTO 8 HRS 770 770 770 770 770 770 SVC000032 AMBULANCE PATIENT TRANSPORT - PARAMEDIC UPTO 8 HRS 550 550 550 550 550 550 PKG021209 COVID-19 PACKAGE - ICU WITH VENTILATOR CARE - GURUGRAM 18000 18000 18000 18000 18000 PKG021210 COVID-19 PACKAGE - ICU WITHOUT VENTILATOR CARE - GURUGRAM 15000 15000 15000 15000 15000 PKG021211 COVID-19 PACKAGE - ISOLATION BEDS - GURUGRAM 10000 10000 10000 10000 10000 SVC000008 CD MAKING 250 300 300 300 300 300 SVC000011 OPD OBSERVATION (UP TO 2 HOURS) 580 SVC000014 INITIAL ASSESSMENT CHARGES 670 1010 1010 1010 1010 1010 SVC000050 MORTUARY SERVICE 1650 1650 1650 1650 1650 SVC000051 PULMONARY ARTERY CATHETERIZATION (PAC) 6600 6600 8580 9900 11220 12540 SVC000064 BED CHARGES - DAY CARE 3200 3200 3200 3200 3200 SVC000089 NONINVASIVE VENTILATOR (NIV) 2900 2900 2900 2900 2900 SVC000100 MEDICAL RECORD CHARGES 200 200 200 200 200 200 SVC000110 OBSERVATION CHARGES - PER HOUR 250 SVC000113 CONSULTATION- DIETITIAN 450 450 450 450 450 450 SVC000118 VENTILATOR - UPTO 12 HOURS 2550 2550 2550 2550 2550 SVC000120 AMBULANCE DOCTOR CHARGES - LONG TRIP 3500 3500 3500 3500 3500 3500 SVC000121 AMBULANCE DOCTOR CHARGES - SHORT TRIP 2750 2750 2750 2750 2750 2750 SVC000143 SILVER - FAMILY CARD 500 500 500 500 500 500 SVC000144 GOLD - SENIOR CITIZEN 600 600 600 600 600 600 SVC000145 PLATINUM - PALTINUM CARD 1000 1000 1000 1000 1000 1000 SVC000146 BED CHARGES - DAY CARE - UPTO 6 HOURS 1600 1600 1600 1600 1600 SVC000147 BED CHARGES - DAY CARE - UPTO 12 HOURS 2800 2800 2800 2800 2800 SVC000166 EMERGENCY CONSULTATION CHARGE 1200 1500 1800 2000 2200 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC000195 BED CHARGES - DAY CARE - UPTO 3 HOURS 1200 1200 1200 1200 1200 SVC000212 CLEFT LIP REPAIR 5720 7440 8580 9730 10870 SVC012373 PPE usage charges 300 550 550 550 550 550 SVC012379 PPE USAGE CHARGES - ER 300 330 330 330 330 330 SVC012394 REMOTE MEDICAL CONSULTATION_A 770 SVC012395 REMOTE MEDICAL CONSULTATION_B 880 SVC012396 REMOTE MEDICAL CONSULTATION_C 1100 SVC012399 REMOTE MEDICAL CONSULTATION_E 770 SVC012413 PPE Usage Charges - Chemo 1100 1100 1100 1100 1100 1100 SVC012414 PPE Usage Charges - Dialysis 300 330 330 330 330 330 SVC012427 COVID-19 TRUENAT 2000 2000 2000 2000 2000 2000 SVC012478 BIOMEDICAL WASTE MANAGEMENT SERVICE 1000 1000 1000 1000 1000 SVC012968 CD REVIEW CHARGES 250 250 250 250 250 250 Blood Bank SVC000238 BLOOD GROUP 110 110 110 110 110 110 SVC000239 FRESH FROZEN PLASMA (FFP) 800 800 800 800 800 800 SVC000240 PACKED RED BLOOD CELLS (PC) 1400 1400 1400 1400 1400 1400 SVC000241 PLATELET CONCENTRATE 850 850 850 850 850 850 SVC000242 PACKED RED BLOOD CELLS (NAT TESTED) 2400 2400 2400 2400 2400 2400 SVC000243 RANDOM DONOR PLATELETPHERESIS (NAT TESTED-FULL BAG) 2500 2500 2500 2500 2500 2500 SVC000244 FRESH FROZEN PLASMA (NAT TESTED) 1600 1600 1600 1600 1600 1600 SVC000245 WHOLE BLOOD 2250 2250 2250 2250 2250 2250 SVC000246 GRANULOCYTOPHERESIS 7650 7650 7650 7650 7650 7650 SVC000248 LEUCOCYTE POOR RED CELLS 1300 1300 1300 1300 1300 1300 SVC000249 SINGLE DONOR PLATELETPHERESIS (HALF BAG) 3450 3450 3450 3450 3450 3450 SVC000250 SINGLE DONOR PLATELETPHERESIS (FULL BAG) 11000 11000 11000 11000 11000 11000 SVC000252 PERIPHERAL BLOOD STEM CELL COLLECTION (PBSC) 12600 12600 12600 12600 12600 12600 SVC000254 CRYO POOR PLASMA 350 350 350 350 350 SVC000255 CRYO PRECIPITATE 500 500 500 500 500 500 SVC000256 BLOOD PRODUCTS IRRADIATION PER UNIT 80 80 80 80 80 80 SVC000257 DIRECT COOMBS TEST 520 520 520 520 520 520 SVC000258 INDIRECT COOMBS TEST 530 530 530 530 530 530 SVC000259 THERAPEUTIC VENESECTION 600 600 600 600 600 600 SVC000260 CROSS-MATCHING CHARGES 600 600 600 600 600 600 SVC000263 LEUCOREDUCED AND IRRADIATED PACKED RED BLOOD CELLS 1350 1350 1350 1350 1350 1350 SVC000265 IRRADIATED PLATELETS 350 350 350 350 350 350 SVC000266 LEUCOREDUCED AND IRRADIATED PLATELETS 420 420 420 420 420 420 SVC000268 WARM AGGLUTININS TEST 210 210 210 210 210 210 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC000271 SDP SCREENING 600 600 600 600 600 600 SVC000272 RANDOM DONOR PLATELETPHERESIS 1600 1600 1600 1600 1600 1600 SVC000273 FRESH FROZEN PLASMA (FFP)_COMPONENT 350 350 350 350 350 SVC000274 PACKED RED BLOOD CELLS (PC) COMP 570 570 570 570 570 SVC000275 PLATELET CONCENTRATE COMP 350 350 350 350 350 SVC000276 SINGLE DONOR PLATELETPHERESIS (FULL BAG) COMP 7700 7700 7700 7700 7700 SVC000277 CRYO PRECIPITATE COMP 220 220 220 220 220 SVC000278 PORTION BAG CHARGES 250 250 250 250 250 250 SVC000280 BLOOD GROUPING & CROSS MATCHING CHARGES 940 940 940 940 940 940 SVC000281 APHRESIS PLATELETS PROCESSING CHARGE 11000 11000 11000 11000 11000 11000 SVC000284 CROSS MATCHING - COMPONENT 780 780 780 780 780 SVC000285 IRRADIATION - COMPONENT 80 80 80 80 80 80 SVC000287 LEUCOFILTRATION - COMPONENT 1300 1300 1300 1300 1300 1300 SVC000288 PACKED RED BLOOD CELLS (PC) -SAGM 960 960 960 960 960 SVC000300 PLATELET CONCENTRATE(NAT TESTED) 1000 1000 1000 1000 1000 1000 SVC012647 CONVALESCENT PLASMAPHERESIS(FULLÂ UNIT ) 12100 12100 12100 12100 12100 12100 SVC012648 CONVALESCENT PLASMAPHERESIS (HALF UNIT) 5780 6050 6050 6050 6050 6050 Breast Surgery SVC000307 BREAST CONSERVATION SURGERY 35970 46760 53960 61150 68340 SVC000308 BREAST RECONSTRUCTION WITH LOCAL FLAP 52800 68640 79200 89760 100320 SVC000310 BREAST - SENTINEL LYMPH NODE BIOPSY 16500 21450 24750 28050 31350 SVC000312 INCISION AND DRAINAGE 6600 8580 9900 11220 12540 SVC000313 LAPAROSCOPIC ABDOMINOPERINEAL RESECTION 35200 45760 52800 59840 66880 SVC000315 MICRODOCHECTOMY 13200 17160 19800 22440 25080 SVC000316 MODIFIED RADICAL MASTECTOMY 41320 53710 61970 70240 78500 SVC000317 RADICAL MASTECTOMY 29480 38320 44220 50120 56010 SVC000324 BREAST LUMPECTOMY 8250 10730 12380 14030 15680 SVC000329 UNILATERAL GYNAECOMASTIA_GST 19910 25880 29870 33850 37830 Cardiac Surgery PKG002613 MVR - A (IM) PKG 225000 292500 337500 382500 427500 PKG002614 MVR + TV REPAIR - A (EM) PKG 270000 351000 405000 459000 513000 PKG002618 AORTIC ARCH REPAIR - A (EM) PKG 275000 357500 412500 467500 522500 PKG002621 AP WINDOW - A (EM) PKG 198000 257400 297000 336600 376200 PKG002622 ARTERIAL SWITCH / ASO - A (EM) PKG 253000 328900 379500 430100 480700 PKG002626 AV CANAL - A (EM) PKG 176000 228800 264000 299200 334400 PKG002630 BD GLEN - A (EM) PKG 165000 214500 247500 280500 313500 PKG002631 BD GLEN ON CPB - A (EM) PKG 165000 214500 247500 280500 313500 PKG002632 BENTAL - A (EM) PKG 198000 257400 297000 336600 376200 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite PKG002633 BT SHUNT - A (EM) PKG 88000 114400 132000 149600 167200 PKG002636 CABG WITH DVR - A (EM) PKG 165000 214500 247500 280500 313500 PKG002637 CABG WITH AVR - A (EM) PKG 242000 314600 363000 411400 459800 PKG002638 CABG WITH MVR - A (EM) PKG 242000 314600 363000 411400 459800 PKG002642 COARCTATION - A (EM) PKG 110000 143000 165000 187000 209000 PKG002646 EBSTEIN - A (EM) PKG 165000 214500 247500 280500 313500 PKG002651 PA BANDING - A (EM) PKG 100000 130000 150000 170000 190000 PKG002652 PDA - A (EM) PKG 90000 117000 135000 153000 171000 PKG002653 PERICARDIECTOMY - A (EM) PKG 132000 171600 198000 224400 250800 PKG002662 TCPC (COMPLETE FONTAN) - A (EM) PKG 198000 257400 297000 336600 376200 PKG002665 TOF - A (EM) PKG 175000 228000 262000 298000 332000 PKG002669 TAPVC - A (EM) PKG 198000 257400 297000 336600 376200 PKG002671 ALCAPA - A (EM) PKG 220000 286000 330000 374000 418000 PKG003374 AVR - A (IM) PKG 225000 292500 337500 382500 427500 PKG003386 RE-DO AVR 275000 357500 412500 467500 522500 PKG003485 DVR - A (IM) PKG 250000 325000 375000 425000 475000 PKG003526 PDA - A (IM) PKG 125000 162500 187500 212500 237500 PKG003554 TOF - A (IM) PKG 250000 325000 375000 425000 475000 PKG003593 CABG - A (IM) PKG 200000 260000 300000 340000 380000 PKG003634 CABG + VSD - A (EM) PKG 275000 357500 412500 467500 522500 PKG005881 VSD - A (IM) PKG 225000 292500 337500 382500 427500 PKG005917 ASD - A (IM) PKG 200000 260000 375000 340000 380000 PKG009058 LEFT VENTRICULAR ASSIST DEVICE (LVAD) IMPLANTATION SURGERY (IM) PKG 1160000 1160000 1160000 1160000 1160000 SVC001372 TAPVC - A 60000 78000 90000 102000 114000 SVC001376 AP WINDOW - A 60000 78000 90000 102000 114000 SVC001377 ARTERIAL SWITCH / ASO - A 82100 106800 123150 139600 156000 SVC001379 AV CANAL - A 53500 70000 80300 91000 102000 SVC001382 AV REPAIR - A 50000 65000 75000 85000 95000 SVC001385 AVR - A 56700 73700 85000 96400 107800 SVC001388 BD GLENN - A 50000 65000 75000 85000 95000 SVC001390 BD GLENN ON CPB - A 50000 65000 75000 85000 95000 SVC001393 BENTALL - A 104000 135200 156000 176800 197600 SVC001396 BT SHUNT - A 20000 26000 30000 34000 38000 SVC001403 CABG WITH AVR - A 73500 95500 110300 125000 140000 SVC001406 CABG WITH DVR - A 45000 58500 67500 76500 85500 SVC001407 CABG WITH MVR - A 73500 95500 110300 125000 140000 SVC001411 COARCTATION - A 25000 32500 37500 42500 47500 SVC001418 DVR - A 80000 104000 120000 136000 152000 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC001421 EBSTEIN - A 50000 65000 75000 85000 95000 SVC001425 MV REPAIR - A 50000 65000 75000 85000 95000 SVC001428 MVR - A 56700 73700 85000 96400 107800 SVC001431 PA BANDING - A 25000 32500 37500 42500 47500 SVC001433 PDA - A 30000 39000 45000 51000 57000 SVC001445 TCPC (COMPLETE FONTAN) - A 60000 78000 90000 102000 114000 SVC001449 TOF - A 58500 76000 87800 99500 110000 SVC001456 VSD - A 53300 69300 80000 90610 101300 SVC001459 AORTIC ARCH REPAIR - A 92600 120400 138900 157400 176000 SVC001465 ASD - A 53300 69300 80000 90610 101300 SVC001470 CABG - A 50000 65000 75000 85000 95000 SVC001473 PERICARDIECTOMY - A 30000 39000 45000 51000 57000 SVC001489 CRT-D IMPLANTATION (BI-VENTRICULAR & PACING) 22000 28600 33000 37400 41800 SVC001490 ALCAPA - A 66500 86500 99800 113000 126500 SVC001498 CABG + VSD - A 50000 65000 75000 85000 95000 SVC001530 ROTABLATION 81070 105390 121610 137820 154030 SVC011950 STERNAL WIRING 8140 10580 12210 13840 15470 Cardiology PKG000395 ANGIOGRAM (IM) PKG 16000 20800 24000 27200 30400 PKG000396 BALLOON ATRIAL SEPTOSTOMY (EM) PKG 24420 31750 36630 41510 46400 PKG000402 ENDOMYOCARDIAL BIOPSY PKG 14850 19310 22280 25250 28220 PKG000409 PERIPHERAL ANGIOGRAM (EM) PKG 6660 8650 9980 11310 12640 PKG000414 CORONARY ANGIOGRAM, RENAL ANGIOGRAM (EM) PKG 6600 8580 9900 11220 12540 PKG000420 AORTIC STENT GRAFTING (EM) PKG 110000 143000 165000 187000 209000 PKG000425 PG REPLACEMENT (EM) PKG 38500 50050 57750 65450 73150 PKG000433 BALOON VALVULOPLASTY - MITRAL (EM) PKG 78650 102250 117980 133710 149440 PKG000443 ASD DEVICE CLOSURE (EM) PKG 69200 90000 104000 117500 131500 PKG000444 CARDIAC CATH, ASD DEVICE CLOSURE (SAME SITTING) (EM) PKG 84200 109500 126000 143000 160000 PKG000445 VSD DEVICE CLOSURE (EM) PKG 137500 178750 206250 233750 261250 PKG003180 ANGIOPLASTY (IM) PKG 125000 162500 187500 212500 237500 PKG003212 PDA DEVICE CLOSURE (IM) PKG 85000 85000 85000 85000 85000 PKG003216 RADIO FREQUENCY ABLATION (IM) PKG 75000 97500 112500 127500 142500 PKG003285 CAROTID ANGIOGRAM (EM) PKG 6050 7870 9080 10290 11500 PKG004877 AICD IMPLANTATION - SINGLE (IM) PKG 80000 87100 120000 136000 152000 PKG004975 CARDIAC CATH (IM) PKG 14000 18200 21000 23800 26600 PKG004993 ELECTRO PHYSIOLOGIC STUDY WITH 2D (IM) PKG 21000 27300 31500 35700 39900 PKG005034 TEMPORARY PACEMAKER IMPLANTATION (TPI) PKG 11000 14300 16500 18700 20900 PKG005062 PACE MAKER IMPLANTATION - SINGLE CHAMBER (IM) PKG 55000 71500 82500 93500 104500 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite PKG005083 PACE MAKER IMPLANTATION - DOUBLE CHAMBER (IM) PKG 80000 104000 120000 136000 152000 PKG005084 CRT - P IMPLANTATION (IM) PKG 120000 156000 180000 204000 228000 PKG005160 AICD IMPLANTATION - DOUBLE (IM) PKG 110000 143000 165000 187000 209000 PKG009436 PERMANENT PACEMAKER IMPLANTATION - DOUBLE CHAMBER (PPI) PKG 66000 85800 99000 112200 125400 PKG009437 PERMANENT PACEMAKER IMPLANTATION - SINGLE CHAMBER (PPI) PKG 46200 60060 69300 78540 87780 PKG010435 ANGIOGRAM DAYCARE (IM) PKG 14000 14000 14000 14000 14000 PKG010437 CRT - D IMPLANTATION (EQUAL TO COMBO) (IM) PKG 130000 169000 195000 221000 247000 PKG019994 INTRA-VASCULAR ULTRASOUND (IVUS) - PKG 33000 42900 49500 56100 62700 PKG021213 RADIO FREQUENCY ABLATION COMPLEX (IM) PKG 95000 123500 142500 161500 180500 PKG021214 PTMC (IM) PKG 80000 104000 120000 136000 152000 SVC000336 AICD IMPLANTATION - SINGLE 33500 43600 50300 57000 63700 SVC000337 ANGIOGRAM 1800 2400 2700 3100 3400 SVC000338 ANGIOPLASTY 61800 80400 92700 105000 117400 SVC000340 ASD DEVICE CLOSURE 38060 49480 57090 64700 72310 SVC000341 BALOON VALVULOPLASTY - MITRAL 35750 46480 53630 60780 67930 SVC000342 CARDIAC CATH 1800 2400 2700 3100 3400 SVC000345 ECG 290 440 440 440 440 440 SVC000346 ECHO SCREENING 1750 2625 2625 2625 2625 2625 SVC000347 ELECTRO PHYSIOLOGIC STUDY WITH 2D 6300 8200 9450 10700 12000 SVC000349 HOLTER MONITORING 2100 3150 3150 3150 3150 3150 SVC000350 IVC FILTER IMPLANTATION 45100 58630 67650 76670 85690 SVC000353 PDA DEVICE CLOSURE 30000 30000 30000 30000 30000 SVC000354 PERIPHERAL ANGIOGRAM 2500 3250 3750 4250 4750 SVC000355 RADIO FREQUENCY ABLATION 30000 39000 45000 51000 57000 SVC000357 STRESS ECHO 3950 5930 5930 5930 5930 5930 SVC000358 TEE 5600 5600 7300 8400 9600 10700 SVC000360 TEMPORARY PACEMAKER IMPLANTATION 13440 17470 20160 22850 25540 SVC000361 TILT TABLE TEST 3470 3470 4500 5200 5890 6580 SVC000362 TREADMILL TEST 1970 1970 1970 1970 1970 1970 SVC000370 PACE MAKER IMPLANTATION - DOUBLE CHAMBER 93800 121940 140700 159460 178220 SVC000371 CRT - P IMPLANTATION 64700 84200 97050 110000 122900 SVC000372 BALOON VALVULOPLASTY - PULMONARY 43560 56630 65340 74050 82760 SVC000373 BALOON ATRIAL SEPTOSTOMY (ONLY PROCEDURE CHARGES) 11110 14440 16670 18890 21110 SVC000375 CARDIAC CATH, ASD DEVICE CLOSURE (SAME SITTING) 46800 60900 70200 79600 89000 SVC000382 CORONARY ANGIOGRAM, RENAL ANGIOGRAM 1800 2340 2700 3060 3420 SVC000386 AORTIC STENT GRAFTING 22000 28600 33000 37400 41800 SVC000388 PG REPLACEMENT 19250 25030 28880 32730 36580 SVC000391 AICD IMPLANTATION - DOUBLE 50000 65000 75000 85000 95000 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC000392 BALOON VALVULOPLASTY - AORTIC 43560 56630 65340 74050 82760 SVC000394 ICD IMPLANTATION - SINGLE FOLLOW UP 1650 2150 2480 2810 3140 SVC000395 PACEMAKER IMPLANTATION - DOUBLE CHAMBER FOLLOW UP 1760 1760 1760 1760 1760 1760 SVC000396 PACEMAKER IMPLANTATION - SINGLE CHAMBER FOLLOW UP 1430 1430 1430 1430 1430 1430 SVC000397 ECHO CARDIOGRAPHY (CRT) 2970 2970 3860 4460 5050 5640 SVC000398 ECHO COLOR DOPPLER 2120 2120 2120 2120 2120 2120 SVC000399 ECHO COLOUR DOPPLER - PEDIATRIC 1970 2060 2060 2060 2060 2060 SVC000400 ECHO SCREENING - PEDIATRIC 2260 2260 2940 3390 3840 4290 SVC000401 FOETAL ECHO 6880 6880 8940 10310 11690 13060 SVC000402 FOETAL ECHO CD CHARGES 170 170 210 250 280 310 SVC000403 CARDIAC MEMOS (PER WEEK) 2810 3650 4210 4770 5330 SVC000404 CARDIAC MEMOS EVENT RECORDING - PER DAY 440 440 570 660 750 840 SVC000405 PERICARDIOCENTESIS (PERICARDIAL TAP) 5700 7500 8600 9700 10900 SVC000408 ANGIOGRAM, FFR 23230 30200 34850 39490 44140 SVC000410 ANGIOPLASTY, FFR 27500 35750 41250 46750 52250 SVC000419 CAROTID ANGIOGRAM 2500 3250 3750 4250 4750 SVC000421 DOBUTAMINE STRESS TEST (ECHO) 4620 6930 6930 6930 6930 6930 SVC000422 MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY 1320 1320 1720 1980 2240 2510 SVC000423 SALINE CONTRAST ECHOCARDIOGRAPHY 690 720 1040 720 1040 1040 SVC000424 DOBUTAMINE STRESS ECHO (INCLUDING CONTRAST CHARGES) 5670 5670 7370 8510 9640 10770 SVC000427 ECHOCARDIOGRAM BEDSIDE 2640 2640 2640 2640 2640 2640 SVC000454 FRACTIONAL FLOW RESERVE (FFR) 33000 42900 49500 56100 62700 SVC000455 OPTICAL COHERENCE TOMOGRAPHY -CORONARY ARTERIES(OCT) 33000 42900 49500 56100 62700 SVC000460 EXTENDED HOLTER MONITORING/PER DAY 1820 1820 1820 1820 1820 1820 SVC002194 CARDIOVERSION 4930 6410 7390 8380 9360 SVC002195 ECHO 2D 2700 2700 3510 4050 4590 5130 SVC011493 ECHO 3D 2500 3750 3750 3750 3750 3750 SVC012885 ELECTROPHYSIOLOGY STUDY + RADIO FREQUENCY ABLATION (EPS+RFA) 58500 76050 87750 99450 111150 Commonn Procedure PKG005234 LYMPH NODE BIOPSY UNDER GA-PKG 15730 20450 23600 26740 29890 PKG007945 PORT INSERTION _PKG 46420 60350 69630 78910 88200 SVC000590 FLUID TAPPING ASCITIC (DIAGNOSTIC) 600 800 900 1100 1200 SVC000591 FOREIGN BODY REMOVAL 4900 6400 7400 8400 9400 SVC000592 INTUBATION 5200 6800 7800 8900 9900 SVC000593 ALPHA BED CHARGES (NIMBUS) - PER DAY 510 510 510 510 510 SVC000594 ALPHA BED CHARGES (TRANS XL) - PER DAY 770 770 770 770 770 SVC000596 DVT PUMP - PER DAY 660 660 660 660 660 SVC000597 MLC CHARGES 830 830 830 830 830 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC000605 IABP 3300 4300 5000 5700 6300 SVC000606 INTERCOSTAL DRAIN INSERTION (ICD INSERTION) 4800 6300 7200 8200 9200 SVC000608 LUMBAR PUNCTURE 4800 6300 7200 8200 9200 SVC000609 PERCUTANEOUS TRACHEOSTOMY 10400 13600 15600 17700 19800 SVC000610 PICC LINE INSERTION 6300 6300 6300 6300 6300 SVC000611 OXYGEN - PER DAY 550 550 550 550 550 SVC000612 INFUSION PUMP - PER DAY 390 390 390 390 390 SVC000613 EXCHANGE TRANSFUSION 12400 16200 18600 21100 23600 SVC000615 FOLEY'S CATHETER REMOVAL 200 300 300 400 400 SVC000616 EXCISION BIOPSY - LA 5500 7200 8300 9400 10500 SVC000621 TRACHEOSTOMY 11000 11000 11000 11000 11000 SVC000634 RYLES TUBE INSERTION 1300 1700 2000 2300 2500 SVC000635 CENTRAL LINE INSERTION - PEDIATRIC 2600 3400 3900 4500 5000 SVC000638 SEDATION CHARGES 3300 4300 5000 5700 6300 SVC000640 SUPERFICIAL ABSCESS DRAINAGE (SINGLE) 1600 2100 2400 2800 3100 SVC000641 SINGLE ABSCESS 1700 2300 2600 2900 3300 SVC000642 T PIECE INSERTION FOR TRACHEOSTOMY 200 300 300 400 400 SVC000643 ECG EMERGENCY 350 525 525 525 525 525 SVC000644 INJECTION IV EMERGENCY 180 270 270 270 270 270 SVC000646 AMBULATORY BP MONITORING - 24 HOURS 2260 3390 3390 3390 3390 3390 SVC000647 LYMPH NODE BIOPSY 5500 7200 8300 9400 10500 SVC000649 EPIDURAL CATHETER INSERTION 4400 5800 6600 7500 8400 SVC000651 INCISIONAL BIOPSY 3300 4300 5000 5700 6300 SVC000657 BOTOX INJECTIONS 6900 6900 9000 10400 11800 13200 SVC000661 CENTRAL LINE DRESSING 300 300 400 500 600 600 SVC000662 GASTRIC LAVAGE/STOMACH WASH 2200 2200 2900 3300 3800 4200 SVC000671 OXYGEN - PER HOUR 60 60 60 60 60 60 SVC000672 VENTILATOR INITIATION AND STABILIZATION 7150 7150 7150 7150 7150 7150 SVC000674 DJ STENT REMOVAL 5300 6900 8000 9100 10100 SVC000678 FOLEY S CATHETERIZATION 1700 1700 2300 2600 2900 3300 SVC000680 WOUND DEBRIDEMENT - LA 8730 8730 8730 8730 8730 SVC000681 DRESSING - WOA 550 550 720 830 940 1050 SVC000682 ENDOSCOPIC REMOVAL OF FOREIGN BODY(FB) 10290 13380 15440 17490 19550 SVC000683 ARTERIAL LINE INSERTION 2750 2750 2750 2750 2750 SVC000684 CENTRAL LINE INSERTION - ADULT 5200 6800 7800 8900 9900 SVC000685 BONE MARROW ASPIRATION 6600 6600 8600 9900 11300 12600 SVC000686 FLUID TAPPING ASCITIC (THERAPEUTIC) 4000 5200 6000 6800 7600 SVC000688 INCISION & DRAINAGE - LA 800 1100 1200 1400 1600 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC000689 SW ENEMA 340 510 510 510 510 510 SVC000690 BLOOD SUGAR STRIP TEST 70 110 110 110 110 110 SVC000691 NEBULISATION 310 310 310 310 310 SVC000693 I.V. FLUID INJECTION CHARGES 150 150 150 150 150 150 SVC000694 INJECTION CHARGES 120 180 180 180 180 180 SVC000695 SLIDE CHARGES 810 810 810 810 810 SVC000696 VACCINATION CHARGES 110 170 170 170 170 170 SVC000697 CONSULTATION - IP 1100 1400 1700 1900 2100 SVC000698 CROSS CONSULTATION - IP 1100 1400 1700 1900 2100 SVC000700 VENTILATOR (BIPAP/CPAP) - PER DAY 4240 4240 4240 4240 4240 SVC000701 C - ARM - PER HOUR 1450 1450 1450 1450 1450 SVC000706 LIGASURE CHARGES 6600 6600 6600 6600 6600 SVC000707 LAPAROSCOPIC INSTRUMENT CHARGES 4950 4950 4950 4950 4950 SVC000714 NURSING CARE PER DAY 2060 2060 2060 2060 2060 SVC000715 NURSING CARE PER DAY - OVERNIGHT 3150 3150 3150 3150 3150 SVC000716 RYLES TUBE FEEDING 910 1370 1370 1370 1370 1370 SVC000717 TRACHEOSTOMY CARE 910 1370 1370 1370 1370 1370 SVC000719 CAVITRON ULTRASOUND SURGICAL ASPIRATOR (CUSA) 4900 6400 7400 8400 9400 SVC000720 SUPRAPUBIC BLADDER ASPIRATION 390 390 390 390 390 SVC000721 COOLING BLANKET - PER DAY 1500 2000 2300 2600 2900 SVC000724 INTUBATION (PAEDIATRIC) 2400 3200 3600 4100 4600 SVC000726 NURSING CHARGES 1000 1000 1000 1000 1000 SVC000730 DRESSING - WOA-MAJOR-OP (INCLUDING MATERIALS) 2100 2100 2800 3200 3600 4000 SVC000735 HOME VISIT CHARGES 600 600 800 900 1100 1200 SVC000736 EQUIPMENT RENTAL CHARGES 800 1100 1200 1400 1600 SVC000737 PEG TUBE FEEDING 1100 1100 1500 1700 1900 2100 SVC000744 SKIN PRICK TEST 930 1400 1400 1400 1400 1400 SVC000746 DRESSINGS LARGE 930 1400 1400 1400 1400 1400 SVC000751 LIFESTYLE MODIFICATION PROGRAM 600 600 800 900 1100 1200 SVC000768 BILIRUBINOMETRY-TRANSCUTANEOUS-(TCB) 300 300 400 500 600 600 SVC000769 HOME SAMPLE COLLECTION CHARGES (LAB) 330 500 500 500 500 500 SVC000774 IV CANNULA INSERTION - EMERGENCY 1000 1300 1500 1700 1900 SVC000778 MANUAL EVACUATION 3700 3700 4900 5600 6300 7100 SVC000808 NEEDLE BIOPSY 3600 3600 4700 5400 6200 6900 SVC000810 GENERAL SUTURE REMOVAL 600 600 800 900 1100 1200 SVC000812 PLAIN CATHERIZATION 2600 3400 3900 4500 5000 SVC000818 AUTOLOGUS SERUM SKIN TEST(ASST) 1800 1800 2400 2700 3100 3500 SVC000819 MINOR DRESSING 500 500 700 800 900 1000 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC000825 ECMO CHARGES PER DAY 22000 22000 22000 22000 22000 SVC000829 PUNCH BIOPSY - LA 2800 2800 3700 4200 4800 5400 SVC000838 HARMONIC SCALPEL - PROBE DISPOSABLE (LAPAROSCOPIC SURGERY) 13070 13070 13070 13070 13070 SVC000839 HARMONIC SCALPEL - PROBE DISPOSABLE (OPEN SURGERY) 4400 4400 4400 4400 4400 SVC000848 ECMO INITIATION CHARGES-COATED 165000 165000 165000 165000 165000 SVC000853 NONINVASIVE VENTILATOR (NIV) FOR 12 HRS 2180 2180 2180 2180 2180 SVC000854 HIGH FLOW NASAL CANNULA DAILY CHARGES 870 870 870 870 870 SVC000855 SUPRAPUBIC CATHETERISATION 4200 5500 6300 7200 8000 SVC000856 HEMODIALYSIS CATHETER INSERTION 3300 4290 4950 5610 6270 SVC000857 TRANS SPHENOIDAL SURGERY 60500 78700 90800 102900 115000 SVC000861 LAP. NEPHRECTOMY RADICAL 47300 61500 71000 80500 89900 SVC000868 WIDE EXCISION 16500 21500 24800 28100 31400 SVC000869 MYOCUTANEOUS / CUTANEOUS FLAP 18700 24400 28100 31800 35600 SVC000878 SINGLE SHOT NERVE BLOCK 4500 5900 6800 7700 8600 SVC000879 CONTINOUS NERVE BLOCK 4400 5800 6600 7500 8400 SVC000880 SHORT SEDATION CHARGES 1450 1450 1450 1450 1450 SVC000881 MEDIUM SEDATION CHARGES 1740 1740 1740 1740 1740 SVC000889 HFNC INITIATION CHARGES 2750 2750 2750 2750 2750 SVC000898 KAOLIN TEST 1720 1720 1720 1720 1720 SVC000899 HEPARINASE TEST 2770 2770 2770 2770 2770 SVC000900 RAPIGRAFF TEST 2310 2310 2310 2310 2310 SVC000901 FIBGRAFF TEST 2420 2420 2420 2420 2420 SVC000902 PLATMETER TEST 13620 13620 13620 13620 13620 SVC002193 BLOOD GAS ANALYSIS 970 1380 1380 1380 1380 1380 SVC011944 TRIPLE SCOPY 5000 6500 7500 8500 9500 SVC011945 TRIPLE SCOPY + BIOPSY 6100 8000 9200 10400 11600 SVC011946 90 DEGREE HOPKINS EXAMINATION 1100 1500 1700 1900 2100 SVC011947 SUTURE REMOVAL LARGE 1700 1700 2300 2600 2900 3300 SVC011948 SUTURE REMOVAL MEDIUM 1100 1100 1500 1700 1900 2100 SVC011949 SECONDARY SUTURING LARGE 5500 5500 7200 8300 9400 10500 SVC012669 PPE Usage Charges - Radiotherapy 1100 1100 1100 1100 1100 1100 SVC012883 CLOSURE COMPLEX 33000 42900 49500 56100 62700 SVC012907 PPE usage charges per day 7000 7000 7000 7000 7000 7000 SVC012910 PRIMARY CLOSURE - SIMPLE 22000 28600 33000 37400 41800 SVC012961 INTRA ARTERIAL RECANALIZATION 28000 36400 42000 47600 53200 Dental PKG013708 DIABETIC HEALTH CHECK 5370 6990 8060 9140 10210 SVC001605 ACRYLIC CROWN 540 540 540 540 540 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC001606 ADDITIONAL CAST PARTIAL DENTURE - PER TOOTH 7590 7590 7590 7590 7590 SVC001608 ALVEOLOPLASTY 2800 3700 4200 4800 5400 SVC001612 BLEACH TRAY_GST 1640 1640 1640 1640 1640 SVC001613 BONE GRAFTING-DENTAL 4220 4220 4220 4220 4220 4220 SVC001622 COMPLETE DENTURE - BIOFUNCTIONAL PROSTHETIC SYSTEM (BPS) WITH EQUIPMENT43890 43890 43890 43890 43890 43890 SVC001623 COMPLETE DENTURE - BIOFUNCTIONAL PROSTHETIC SYSTEM (BPS) WITHOUT 42350EQUIPMENT42350 (PROCESSING)42350 42350 42350 42350 SVC001624 COMPLETE DENTURE BPS WITH EQUIPMENT- SINGLE ARCH 24140 24140 24140 24140 24140 24140 SVC001627 COMPOSITE COSMETIC FILLING - CLASS II 830 830 830 830 830 830 SVC001628 COMPOSITE COSMETIC FILLING- CLASS I PIT 1200 1200 1200 1200 1200 1200 SVC001629 COMPOSITE COSMETIC FILLING MESIO OCCLUSAL DISTAL 1200 1200 1200 1200 1200 1200 SVC001630 COMPOSITE COSMETIC FILLING-CLASS III/IV/V 1460 1460 1460 1460 1460 1460 SVC001631 COMPOSITE INLAY 11540 11540 11540 11540 11540 11540 SVC001632 COMPOSITE RESTORATION 2190 2190 2190 2190 2190 2190 SVC001634 CROWN CEMENTATION 730 730 730 730 730 730 SVC001635 CROWN FULL CERAMIC_GST 10890 10890 10890 10890 10890 10890 SVC001636 CROWN LENGHTENING_GST 3510 3510 3510 3510 3510 3510 SVC001637 CROWN METAL 6040 6040 6040 6040 6040 6040 SVC001638 CROWN PORCELAIN FUSED METAL (PFM) 7340 7340 7340 7340 7340 7340 SVC001639 CROWN PROCERA_GST 14840 14840 14840 14840 14840 14840 SVC001640 CROWN REMOVAL 540 540 540 540 540 540 SVC001641 CYST MANAGEMENT 17750 17750 17750 17750 17750 17750 SVC001642 DECIDUOUS TOOTH EXTRACTION 1100 1100 1500 1700 1900 2100 SVC001652 FLAP SURGERY - PER QUADRANT 5240 5240 5240 5240 5240 5240 SVC001653 FLEXIBLE REMOVABLE PARTIAL DENTURE (RPD) - BASE & ONE TOOTH 9440 9440 9440 9440 9440 9440 SVC001654 FLEXIBLE REMOVABLE PARTIAL DENTURE (RPD) - ADDITIONAL TOOTH 6590 6590 6590 6590 6590 6590 SVC001655 FLUORIDE APPLICATION 1570 1570 1570 1570 1570 1570 SVC001657 FRENECTOMY 6590 6590 6590 6590 6590 6590 SVC001664 GOLD CROWN 50490 50490 50490 50490 50490 50490 SVC001667 HOME BLEACHING_GST 4940 4940 4940 4940 4940 4940 SVC001668 IMMEDIATE COMPLETE DENTURE 15290 15290 15290 15290 15290 15290 SVC001669 IMPLANT DENTURE WITH TWO NORMAL ATTACHMENTS 22990 22990 22990 22990 22990 22990 SVC001670 IMPLANT OVER DENTURE WITH TWO IMPORTED ATTACHMENTS 11540 11540 11540 11540 11540 11540 SVC001672 IMPORTED COMPLETE DENTURE 13200 13200 13200 13200 13200 13200 SVC001674 INCISION & DRAINAGE - DENTAL 9400 14100 18330 21150 23970 26790 SVC001678 INTRA ORAL PERI APICAL (IOPA) RADIOGRAPH - DIGITAL 160 240 240 240 240 240 SVC001681 LASER - BLEACHING_GST 26760 26760 26760 26760 26760 26760 SVC001684 LASER - FLAP SURGERY PER QUADRANT 9340 9340 9340 9340 9340 9340 SVC001685 LASER - FRENECTOMY 9890 9890 9890 9890 9890 9890 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC001686 LASER - GINGIVECTOMY 1990 1990 1990 1990 1990 1990 SVC001688 LASER - OPERCULECTOMY 4990 4990 4990 4990 4990 4990 SVC001690 LATERAL CEPHALOGRAM 900 1350 1350 1350 1350 1350 SVC001692 LINGUAL ORTHODONTIC_GST 189900 189900 189900 189900 189900 SVC001693 LOCAL DRUG DELIVERY 1750 1750 1750 1750 1750 1750 SVC001698 METAL BASED DENTURE 50710 50710 50710 50710 50710 50710 SVC001703 NORMAL COMPLETE DENTURE 27490 27490 27490 27490 27490 27490 SVC001704 NORMAL COMPLETE DENTURE - SINGLE ARCH 18690 18690 18690 18690 18690 18690 SVC001707 OCCLUSAL SPLINT 3620 3620 3620 3620 3620 3620 SVC001709 OFFICE BLEACHING 9790 9790 9790 9790 9790 9790 SVC001710 OFFICE BLEACHING WITH HOME BLEACHING KIT EXTRA BOOST 2650 2650 2650 2650 2650 2650 SVC001711 OPERCULECTOMY 3300 3300 4300 5000 5700 6300 SVC001713 ORTHO PANTO GRAM (OPG) 490 740 740 740 740 740 SVC001716 ORTHODONTIC FUNCTIONAL APPLIANCES 21890 21890 21890 21890 21890 21890 SVC001717 ORTHOPAEDIC APPLIANCES 6480 6480 6480 6480 6480 6480 SVC001718 PEDO CROWN 6490 6490 6490 6490 6490 6490 SVC001722 PIT & FISSURE SEALANT - DECIDUOUS TOOTH 730 730 730 730 730 730 SVC001723 PIT & FISSURE SEALANT - PERMANENT TOOTH 1150 1150 1150 1150 1150 1150 SVC001724 POLYCORBOXYLATE CROWNS 980 980 980 980 980 980 SVC001725 POSTERIOR CEPHALOGRAM 900 1350 1350 1350 1350 1350 SVC001726 PRECISION ATTACHMENT WITH TWO CROWNS 5770 5770 5770 5770 5770 5770 SVC001730 PULPOTOMY 2850 2850 2850 2850 2850 2850 SVC001733 RCT - INCISORS 3670 3670 3670 3670 3670 3670 SVC001734 RCT - MOLARS 4390 4390 4390 4390 4390 4390 SVC001735 RCT - OPEN APEX 2740 2740 2740 2740 2740 2740 SVC001736 RCT - PREMOLARS 10340 10340 10340 10340 10340 10340 SVC001737 RCT - WISDOM TOOTH 3290 3290 3290 3290 3290 3290 SVC001740 REMOVABALE ORTHODONTIC APPLIANCES 6040 6040 6040 6040 6040 6040 SVC001741 REMOVABLE ORTHODONTIC RETAINER 4720 4720 4720 4720 4720 4720 SVC001742 REMOVABLE PARTIAL DENTURE (RPD) ADDITIONAL TOOTH 540 540 540 540 540 540 SVC001743 REMOVABLE PARTIAL DENTURE (RPD) PER TOOTH 730 730 730 730 730 730 SVC001745 RE-RCT- INCISORS 6590 6590 6590 6590 6590 6590 SVC001746 RE-RCT-MOLARS 7340 7340 7340 7340 7340 7340 SVC001747 RE-RCT-PREMOLARS 5670 5670 5670 5670 5670 5670 SVC001754 SEMI RIGID PARTIAL DENTURE - SUN FLEX 6700 6700 6700 6700 6700 6700 SVC001755 SEMI RIGID PARTIAL DENTURE - SUN FLEX - ADDITIONAL TOOTH 1200 1200 1200 1200 1200 1200 SVC001759 SINGLE TOOTH IMPLANT 32890 32890 32890 32890 32890 32890 SVC001760 SINUS LIFT 24090 24090 24090 24090 24090 24090 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC001765 STRAIGHT WIRE ORTHODONTICS -CERAMIC BRACES 26290 26290 26290 26290 26290 26290 SVC001766 STRIP CROWN 2190 2190 2190 2190 2190 2190 SVC001767 STUDY MODEL 650 650 650 650 650 650 SVC001768 SUBGINGIVAL CURETTAGE 3290 3290 3290 3290 3290 3290 SVC001770 SUPER SPLINT 4390 4390 4390 4390 4390 4390 SVC001771 SUPRA GINGIVAL SCALING AND POLISHING 760 760 760 760 760 760 SVC001774 SUTURE REMOVAL 620 620 620 620 620 620 SVC001776 TEMPORARY CROWN 6590 6590 6590 6590 6590 6590 SVC001777 TEMPORARY DENTURE 12860 12860 12860 12860 12860 12860 SVC001778 TEMPORARY FILLING 520 520 520 520 520 520 SVC001782 TITANIUM CAST PARTIAL DENTURE 64790 64790 64790 64790 64790 64790 SVC001788 TRANSITIONAL IMPLANT 47190 47190 47190 47190 47190 47190 SVC001789 VESTIBULOPLASTY 9010 9010 9010 9010 9010 9010 SVC001791 ZIRCONIA CROWN_GST 18800 18800 18800 18800 18800 18800 SVC001798 APICOECTOMY MULTIPLE ROOT 10990 10990 10990 10990 10990 10990 SVC001802 BITE RAISING APPLIANCE/ NIGHT GUARD 2620 2620 2620 2620 2620 2620 SVC001803 BONE AUGMENTATION 14600 14600 14600 14600 14600 14600 SVC001808 FRACTURE MANDIBLE(LOCAL ANESTHESIA) 10890 10890 10890 10890 10890 10890 SVC001814 HISTOPATHOLOGY(LAB PROCEDURE FOR BIOPSY) 4390 4390 4390 4390 4390 4390 SVC001817 LASER PROCEDURE MAJOR 4940 4940 4940 4940 4940 4940 SVC001821 MISCELLANEOUS ORTHODONTICS 3560 3560 3560 3560 3560 3560 SVC001830 STAINLESS STEEL CROWN 4500 4500 4500 4500 4500 4500 SVC001833 TEMPORO MANDIBULAR JOINT DISLOCATION MANAGEMENT 1100 1100 1500 1700 1900 2100 SVC001837 FIXED PARTIAL DENTURE- (1 UNIT) - CERAMIC 5290 5290 5290 5290 5290 5290 SVC001838 FIXED PARTIAL DENTURE- (1 UNIT) - METAL 7690 7690 7690 7690 7690 7690 SVC001841 PARTIAL REMOVABLE DENTURE - UNIT 28490 28490 28490 28490 28490 28490 SVC001842 CYST MANAGEMENT GRADE IV 24090 24090 24090 24090 24090 SVC001843 IMPLANT TYPE -I 28490 28490 28490 28490 28490 28490 SVC001844 IMPLANT TYPE -II 38220 38220 38220 38220 38220 38220 SVC001845 IMPLANT TYPE -III 52400 52400 52400 52400 52400 52400 SVC001846 IMPLANT WITH BONEGRAFT & MEMBRANE 14190 14190 14190 14190 14190 14190 SVC001847 SINUSLIFT II 40590 40590 40590 40590 40590 40590 SVC001853 STAINLESS STEEL CROWN FOR PEDIATRIC II 3290 3290 3290 3290 3290 3290 SVC001854 STAINLESS STEEL CROWN FOR PEDIATRIC III 3290 3290 3290 3290 3290 3290 SVC001856 FLUORIDE APPLICATION II 2630 2630 2630 2630 2630 2630 SVC001857 FLUORIDE APPLICATION III 870 870 870 870 870 870 SVC001860 PARTIAL FIXED ORTHODONTIC TREATMENT I 13100 13100 17100 19700 22300 24900 SVC001862 ORTHO SINGLE JAW (METAL) 31790 31790 31790 31790 31790 31790 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC001863 ORTHO SINGLE JAW (CERAMIC) 76890 76890 76890 76890 76890 76890 SVC001864 FULL DENTURE- TYPE I U & L 21990 21990 21990 21990 21990 21990 SVC001865 FULL DENTURE- TYPE II U & L 16490 16490 16490 16490 16490 16490 SVC001866 FULL DENTURE- TYPE III U & L 24090 24090 24090 24090 24090 24090 SVC001867 FULL DENTURE- TYPE IV U & L 64790 64790 64790 64790 64790 64790 SVC001868 FULL DENTURE REPAIR( WITH LAB CHARGES) 7340 7340 7340 7340 7340 7340 SVC001869 SINGLE DENTURE- TYPE I 11990 11990 11990 11990 11990 11990 SVC001870 SINGLE DENTURE- TYPE II 18040 18040 18040 18040 18040 18040 SVC001871 SINGLE DENTURE- TYPE III 18040 18040 18040 18040 18040 18040 SVC001873 SINGLE DENTURE REPAIR( MINOR) 5600 5600 5600 5600 5600 5600 SVC001874 SINGLE DENTURE REPAIR( WITH LAB CHARGES) 4940 4940 4940 4940 4940 4940 SVC001886 PORCELAIN FUSED METAL CROWN II 5270 5270 5270 5270 5270 5270 SVC001895 BLEACHING ( PER TOOTH) 15290 15290 15290 15290 15290 15290 SVC001896 SCALING & POLISHING TYPE I 1800 1800 2400 2700 3100 3500 SVC001897 SCALING & POLISHING TYPE II 1670 1670 1670 1670 1670 1670 SVC001901 STRAIGHT WIRE ORTHODONTIC- METAL BRACES TYPE-I 29590 29590 29590 29590 29590 29590 SVC001902 STRAIGHT WIRE ORTHODONTIC- METAL BRACES TYPE-II 47190 47190 47190 47190 47190 47190 SVC001903 STRAIGHT WIRE ORTHODONTICS -CERAMIC BRACES TYPE-I 98890 98890 98890 98890 98890 98890 SVC001904 STRAIGHT WIRE ORTHODONTICS -CERAMIC BRACES TYPE-II 65890 65890 65890 65890 65890 65890 SVC001909 CROWN FULL CERAMIC TYPE-II (PER UNIT) 9560 9560 9560 9560 9560 9560 SVC001910 CROWN PORCELAIN FUSED METAL (PFM) TYPE-II (PER UNIT) 6590 6590 6590 6590 6590 6590 SVC001911 NORMAL COMPLETE DENTURE TYPE-I 15740 15740 15740 15740 15740 15740 SVC001912 NORMAL COMPLETE DENTURE TYPE-II 10990 10990 10990 10990 10990 10990 SVC001914 OPEN REDUCTION AND INTERNAL FIXATION (ORIF) 30690 30690 30690 30690 30690 30690 SVC001919 ROOT CANAL TREATMENT (RCT) ANTERIOR TEETH 6000 6000 7800 9000 10200 11400 SVC001920 ROOT CANAL TREATMENT (RCT) POSTERIOR TEETH 7200 7200 9400 10800 12300 13700 SVC001923 CROWN ALL CERAMIC /UNIT - EMPRESS 13090 13090 13090 13090 13090 13090 SVC001924 DENTURE COMPLETE- SINGLE ARCH HIGH STRENGTH 99000 99000 99000 99000 99000 99000 SVC001925 BLEACHING OF TEETH SINGLE ARCH(HOME BLEACH) 2190 2190 2190 2190 2190 2190 SVC001926 BLEACHING OF TEETH DOUBLE ARCH(HOME BLEACH) 1550 1550 1550 1550 1550 1550 SVC001927 CORONOPLASTY/TOOTH 600 600 800 900 1100 1200 SVC001930 ROOT CANAL TREATMENT(RCT)ROTARY 7040 7040 7040 7040 7040 7040 SVC001932 BIOPSY EXCISIONAL(DENTAL) 9400 9400 12300 14100 16000 17900 SVC001933 BIOPSY INCISIONAL(DENTAL) 4190 4190 4190 4190 4190 4190 SVC001934 EXTRACTION ERUPTED WISDOM TOOTH 3800 3800 5000 5700 6500 7300 SVC001935 EXTRACTION IMPACTED(DISTOANGULAR) 6600 6600 8600 9900 11300 12600 SVC001936 EXTRACTION IMPACTED(MESIOANGULAR) 5500 5500 7200 8300 9400 10500 SVC001937 EXTRACTION PER TOOTH UNDER LA 1700 1700 2300 2600 2900 3300 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC001940 GINGIVAL RESHAPING WITH LASER/TOOTH 10990 10990 10990 10990 10990 10990 SVC001942 LEUKOPLAKIA REMOVAL WITH LASER-MEDIUM 10990 10990 10990 10990 10990 10990 SVC001943 METAL FREE CROWN 20450 20450 20450 20450 20450 20450 SVC001944 EXTRACTION ERUPTED WISDOM TOOTH SURGICALY 3900 3900 5100 5900 6700 7500 SVC001947 GUM TREATMENT WITH LASER 1860 1860 1860 1860 1860 1860 SVC001948 GUM TREATMENT WITH LASER/ QUADRANT 6040 6040 6040 6040 6040 6040 SVC001949 GUM TREATMENT WITH LASER/ TOOTH 1640 1640 1640 1640 1640 1640 SVC001950 SPLINT 3190 3190 3190 3190 3190 3190 SVC001956 REMOVABLE PARTIAL DENTURE- METAL BASED FOR EVERY SINGLE TEETH AFTER1090 3 TEETH 1090 1090 1090 1090 1090 SVC001957 CROWN FULL CERAMIC_NON GST 9650 9650 9650 9650 9650 9650 SVC001958 CROWN PROCERA_NON GST 17490 17490 17490 17490 17490 17490 SVC001959 ZIRCONIA CROWN_NON GST 17040 17040 17040 17040 17040 17040 SVC001963 METAL FREE CROWN- 3M LAVA ESSENTIAL 18800 18800 18800 18800 18800 18800 SVC001964 METAL FREE CROWN- EMAX 11540 11540 11540 11540 11540 11540 SVC001965 RCT - POSTERIOR TYPE I 6820 6820 6820 6820 6820 6820 SVC001967 RCT - POSTERIOR TYPE II 4720 4720 4720 4720 4720 4720 SVC001969 RCT - POSTERIOR TYPE III 6590 6590 6590 6590 6590 6590 SVC001970 RCT - POSTERIOR TYPE IV 13190 13190 13190 13190 13190 13190 SVC001971 SCALING AND POLISHING ADDITIONAL SITTING 430 430 430 430 430 430 SVC001980 SPLINTS (6 ANTERIORS) 2620 2620 2620 2620 2620 2620 SVC002001 APICOECTOMY ANTERIOR PER TOOTH 7690 7690 7690 7690 7690 7690 SVC002002 APICOECTOMY POSTERIOR PER TOOTH 8790 8790 8790 8790 8790 8790 SVC002006 RESTORATION LIGHT CURE GIC (CERVICAL) 1990 1990 1990 1990 1990 1990 SVC002007 ALVEOLOPLASTY/TOOTH AREA 3950 3950 3950 3950 3950 3950 SVC002014 FRENECTOMY/FRENOTOMY WITH LASER(LINGUAL) 6590 6590 6590 6590 6590 6590 SVC002015 RESTORATION MIRACLEMIX I SURFACE 1460 1460 1460 1460 1460 1460 SVC002016 RESTORATION MIRACLEMIX II SURFACE 1860 1860 1860 1860 1860 1860 SVC002018 REMOVABLE PARTIAL DENTURE-ACRYLIC BASED-MORE THAN 3 TEETH 1640 1640 1640 1640 1640 1640 SVC002028 TOOTH ADDITION IN A DENTURE/TOOTH 1200 1200 1200 1200 1200 1200 SVC002029 BONE GRAFT ON EACH IMPLANT 12090 12090 12090 12090 12090 12090 SVC002030 IMPLANT 1ST PHASE (1) 36190 36190 36190 36190 36190 36190 SVC002031 IMPLANT 2ND PHASE(2) 25190 25190 25190 25190 25190 25190 SVC002032 IMPLANT 3RD PHASE(3) 30690 30690 30690 30690 30690 30690 SVC002033 CUSPAL GRINDING PER TOOTH 9440 9440 9440 9440 9440 9440 SVC002037 PERIODONTAL FLAP SURGERY(FULL MOUTH) 11540 11540 11540 11540 11540 11540 SVC002048 RESTORATION COMPOMER/GIOMER 830 830 830 830 830 830 SVC002050 RESTORATION GIC II SURFACE 1670 1670 1670 1670 1670 1670 SVC002051 RESTORATION LIGHT CURE COMPOSITE I SURFACE 2100 2100 2800 3200 3600 4000 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC002052 RESTORATION LIGHT CURE COMPOSITE II SURFACE 2200 2200 2900 3300 3800 4200 SVC002053 RESTORATION LIGHT CURE GIC CORE BUILD UP 2080 2080 2080 2080 2080 2080 SVC002064 FIXED FULL MOUTH - CERAMIC 1ST PAYMENT OF ORTHO T/T 26290 26290 26290 26290 26290 26290 SVC002065 FIXED FULL MOUTH - CERAMIC 2ND PAYMENT OF ORTHO T/T 45050 45050 45050 45050 45050 45050 SVC002066 FIXED FULL MOUTH - CERAMIC 3RD PAYMENT OF ORTHO T/T 51590 51590 51590 51590 51590 51590 SVC002067 FIXED FULL MOUTH - CERAMIC 4TH PAYMENT OF ORTHO T/T 87890 87890 87890 87890 87890 87890 SVC002068 FIXED FULL MOUTH - CERAMIC 5TH PAYMENT OF ORTHO T/T 49390 49390 49390 49390 49390 49390 SVC002069 FIXED FULL MOUTH-METAL(ORTHODONTIC) 64790 64790 64790 64790 64790 64790 SVC002070 FIXED FULL MOUTH-METAL 1ST PAYMENT OF ORTHO T/T 43890 43890 43890 43890 43890 43890 SVC002071 FIXED FULL MOUTH-METAL 2ND PAYMENT OF ORTHO T/T 3510 3510 3510 3510 3510 3510 SVC002072 FIXED FULL MOUTH-METAL 3RD PAYMENT OF ORTHO T/T 16390 16390 16390 16390 16390 16390 SVC002073 FIXED FULL MOUTH-METAL 4TH PAYMENT OF ORTHO T/T 59290 59290 59290 59290 59290 59290 SVC002088 REMOVABLE ORTHODONTICS-FULL PAYMENT 5770 5770 5770 5770 5770 5770 SVC002089 REMOVABLE ORTHODONTICS-IST INSTALLMENTS 760 760 760 760 760 760 SVC002090 REMOVABLE ORTHODONTICS-IIND INSTALLMENTS 3670 3670 3670 3670 3670 3670 SVC002091 APEXIFICATION MULTIPLE VISIT(CA(OH)2 6590 6590 6590 6590 6590 6590 SVC002092 APEXIFICATION TWO VISIT (MTA) 7140 7140 7140 7140 7140 7140 SVC002100 APICOECTOMY PER ADDITIONAL TOOTH 12090 12090 12090 12090 12090 12090 SVC002101 ARCHBAR FIXATION DENTOALVEOLAR FRACTURE SEGMENT 5390 5390 5390 5390 5390 5390 SVC002103 BIOPSY INCISIONAL - SOST TISSUE 4400 4400 5800 6600 7500 8400 SVC002104 CLOSED REDUCTION OF DISPLASED MANDIBULAR FRACTURE (MULTIPLE) 49390 49390 49390 49390 49390 49390 SVC002105 CLOSED REDUCTION OF LF I 30140 30140 30140 30140 30140 30140 SVC002106 CLOSED REDUCTION OF LF I WITH MPS 17490 17490 17490 17490 17490 17490 SVC002110 CYST &TUMOUR OF MAXILLA /MANDIBLE BY ENUCLEATION/ EXCISION/MARSUPALISATION25190 25190 UPTO 4 CMS25190 UNDER LA25190 25190 25190 SVC002111 CYST &TUMOUR OF MAXILLA /MANDIBLE BY ENUCLEATION/ EXCISION/MARSUPALISATION14290 14290 SIZE MORE 14290THAN 4 CMS14290 UNDER14290 GA 14290 SVC002112 CYST &TUMOUR OF MAXILLA /MANDIBLE BY ENUCLEATION/ EXCISION/MARSUPALISATION15290 15290 SIZE MORE 15290THAN 4 CMS15290 UNDER15290 LA 15290 SVC002113 EXCISION TUMOUR ODONTOGENIC SMALL 19690 19690 19690 19690 19690 19690 SVC002114 EXPOSURE TOOTH SURGICAL ( LABIAL) 620 620 620 620 620 620 SVC002115 EXPOSURE TOOTH SURGICAL ( PALATAL) 1640 1640 1640 1640 1640 1640 SVC002116 EXTRACTION IMPACTED (HORIZONTAL)3RD MOLAR 7700 7700 10100 11600 13100 14700 SVC002117 EXTRACTION IMPACTED 3RD MOLAR (AT LOWER BORDER OF MANDIBLE) 6590 6590 6590 6590 6590 6590 SVC002119 EXTRACTION IMPACTED CLASS II 3RD MOLAR 7690 7690 7690 7690 7690 7690 SVC002120 EXTRACTION IMPACTED CLASS III 3RD MOLAR 12100 12100 15800 18200 20600 23000 SVC002122 EXTRACTION OF IMPACTED TOOTH UNDER LA 5500 5500 7200 8300 9400 10500 SVC002123 EXTRACTION ROOT STUMP SURGICAL 3800 3800 5000 5700 6500 7300 SVC002132 ODONTOGENIC CYST ENUCLEATION LARGE 47190 47190 47190 47190 47190 47190 SVC002133 ODONTOGENIC CYST ENUCLEATION SMALL 18590 18590 18590 18590 18590 18590 SVC002134 PRE-PROSTHETIC SURGERY - RIDGE AUGMENTATION (PER QUARANT) 8300 8300 8300 8300 8300 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC002136 REDUCTION & IMMOBILASATION OF FRACTURE-MAXILLA UNDER LA 16390 16390 16390 16390 16390 SVC002137 REDUCTION & IMMOBILASATION OF FRACTURE-MANDIBLE UNDER LA 49390 49390 49390 49390 49390 SVC002138 RELEASE OF FIBROUS BANDS & GRAFTING - IN (OSMF) TREATMENT UNDER GA 8570 8570 8570 8570 8570 SVC002147 CLOSURE OF ORO-ANTRAL FISTULA 18590 18590 18590 18590 18590 SVC002152 INTRA ARTICUAR INJECTION 330 330 330 330 330 330 SVC002153 INTRA LESIONAL INJECTION IN OSMF /INJ 1250 1250 1250 1250 1250 1250 SVC002156 SOCKET DRESSING (DENTAL)/VISIT 2740 2740 2740 2740 2740 2740 SVC002166 CROWN LENGTHNING WITH LASER/TOOTH 3290 3290 3290 3290 3290 3290 SVC002169 LASER DEPIGMENTATION PER TOOTH 6590 6590 6590 6590 6590 6590 SVC002170 LASER STERILIZATION/ROOTH CANAL 2190 2190 2190 2190 2190 2190 SVC002171 LASER THERAPY FOR APTHOUS AND HERPETIC ULCERS/AREA 2740 2740 2740 2740 2740 2740 SVC002172 LEUKOPLAKIA REMOVAL WITH LASER-LARGE 8240 8240 8240 8240 8240 8240 SVC002173 LEUKOPLAKIA REMOVAL WITH LASER-SMALL 5490 5490 5490 5490 5490 5490 SVC002174 MUCOCOELE REMOVAL WITH LASER 2740 2740 2740 2740 2740 2740 SVC002178 TOOTH BLEACHING WITH LASER PER QUADRANT 18690 18690 18690 18690 18690 18690 Dermetology SVC001576 CHEMICAL PEEL_GST 2920 3790 4370 4960 5540 SVC001577 ELECTRO CAUTERY / RADIOFREQUENCY (2 - 5 LESIONS)_GST 4350 5650 6520 7390 8260 SVC001578 ELECTRO CAUTERY / RADIOFREQUENCY (5 - 20 LESIONS)_GST 5390 7010 8090 9160 10240 SVC001579 ELECTRO CAUTERY / RADIOFREQUENCY (SINGLE LESION)_GST 760 990 1140 1290 1440 SVC001580 INTRALESIONAL INJECTION (PER INJECTION) FOR KELOIDS 880 880 1140 1320 1500 1670 SVC001581 MOLLUSCUM CURETTAGE (2 - 5 LESIONS)_GST 3850 5010 5780 6550 7320 SVC001582 MOLLUSCUM CURETTAGE (5 - 20 LESIONS)_GST 4150 5350 6200 7000 7850 SVC001583 MOLLUSCUM CURETTAGE (SINGLE LESION)_GST 760 990 1140 1290 1440 SVC001584 PATCH TEST 2920 2920 3790 4370 4960 5540 SVC001585 SKIN BIOPSY 1700 1700 2200 2550 2850 3200 SVC001586 PRICK TEST FOR FOOD PROFILE 13200 13200 17160 19800 22440 25080 SVC001588 CRYOTHERAPY_GST 1490 1490 1930 2230 2520 2820 SVC001590 ACNE THERAPY_GST 2090 2090 2720 3140 3550 3970 ENT PKG003717 TONSILLECTOMY_PKG 45870 59630 68810 77980 87150 PKG006162 ADENOTONSILLECTOMY PKG 49500 64350 74250 84150 94050 PKG010490 TYMPANOPLASTY_PKG 66000 85800 99000 112200 125400 PKG014659 MASTOIDECTOMY SIMPLE_PKG 38500 50050 57750 65450 73150 SVC000222 SPEECH AUDIOMETRY 530 530 690 800 900 1010 SVC000226 TINNITUS RETRAINING 630 630 820 950 1070 1200 SVC000227 SPEECH THERAPY 770 770 1000 1160 1310 1460 SVC000234 ASSR - ACOUSTIC STEADY STATE RESPONSE 4950 4950 6440 7430 8420 9410 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC002200 FIBRE OPTIC LARYNGOSCOPY 3540 3540 4600 5310 6020 6730 SVC002201 HEARING AID TRIAL 530 530 690 800 900 1010 SVC002202 PURE TONE AUDIOMETRY (PTA) 740 740 960 1110 1260 1410 SVC002203 PURE TONE AUDIOMETRY + TYMPANOMETRY 970 970 1260 1450 1650 1840 SVC002204 TYMPANOMETRY 840 840 1090 1260 1430 1600 SVC002205 EAR LOBE REPAIR - BOTH SIDES_GST 1160 1160 1500 1730 1960 2190 SVC002206 EAR LOBE REPAIR - ONE SIDE_GST 670 670 870 1010 1140 1270 SVC002207 NASAL ENDOSCOPY (DIAGNOSTIC) 1050 1050 1360 1570 1780 1990 SVC002209 VIDEOLARYNGOSCOPY 1540 1540 2000 2310 2620 2930 SVC002211 CORTICAL MASTOIDECTOMY 17050 22170 25580 28990 32400 SVC002212 DIRECT LARYNGOSCOPY 3630 4720 5450 6170 6900 SVC002215 ENDOSCOPIC MASTOIDECTOMY 15180 19730 22770 25810 28840 SVC002217 ENDOSCOPIC NASAL CAUTERISATION 15180 19730 22770 25810 28840 SVC002218 ENDOSCOPIC OPTIC NERVE DECOMPRESSION 63360 82370 95040 107710 120380 SVC002223 ENDOSCOPIC TYMPANOPLASTY 29700 38610 44550 50490 56430 SVC002227 PREAURICULAR SINUS EXCISION (UNILATERAL) 9240 12010 13860 15710 17560 SVC002228 RADICAL MASTOIDECTOMY 34980 45470 52470 59470 66460 SVC002229 RADICAL MODIFIED MASTOIDECTOMY 36960 48050 55440 62830 70220 SVC002230 RHINOLITH REMOVAL 690 900 1040 1180 1320 SVC002231 SEPTAL HAEMATOMA DRAINAGE 11880 15440 17820 20200 22570 SVC002232 SURGICAL TREATMENT OF LARYNGOFISSURE 27390 35610 41090 46560 52040 SVC002233 TONSILLECTOMY 22990 29890 34490 39080 43680 SVC002236 UVULO - PALATO PHARYNGOPLASTY 28930 37610 43400 49180 54970 SVC002237 AURAL POLYP EXCISION 970 970 1260 1450 1650 1840 SVC002238 THERAPY FOR HEARING IMPAIRED 500 500 640 740 840 940 SVC002242 ENDOSCOPIC ORBITAL DECOMPRESSION 40260 52340 60390 68440 76490 SVC002245 ADENOIDECTOMY 11880 15440 17820 20200 22570 SVC002246 FRACTURE NASAL BONES 24090 31320 36140 40950 45770 SVC002249 NASAL PACK REMOVAL 700 700 920 1060 1200 1340 SVC002252 ADENOTONSILLECTOMY 18480 24020 27720 31420 35110 SVC002254 NASAL PACKING FOR EPISTAXIS 690 690 900 1040 1180 1320 SVC002256 TYMPANOMASTOIDECTOMY 34650 45050 51980 58910 65840 SVC002257 ENDOSCOPIC REMOVAL OF FOREIGN BODY 1100 1100 1430 1650 1870 2090 SVC002261 SEPTOPLASTY 21890 28460 32840 37210 41590 SVC002262 ENDOSCOPIC DACRYOCYSTORHINOSTOMY (DCR) 19690 25600 29540 33470 37410 SVC002263 MYRINGOTOMY WITH GROMMET INSERTION 2860 3720 4290 4860 5430 SVC002264 NASAL MASS EXCISION - LATERAL RHINOTOMY 31240 40610 46860 53110 59360 SVC002270 INCISION AND DRAINAGE -EAR HAEMATOMA(OPP) 1650 1650 2150 2480 2810 3140 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC002271 INCISION AND DRAINAGE -NECK ABSCESS(OPP) 1650 1650 2150 2480 2810 3140 SVC002272 KELOID EXCISION - PINNA(OPP) 2200 2200 2860 3300 3740 4180 SVC002273 LYMPH NODE BIOPSY - NECK(OPP) 1650 1650 2150 2480 2810 3140 SVC002274 NASAL CAUTERIZATION(OPP) 1650 1650 2150 2480 2810 3140 SVC002275 FOREIGN BODY REMOVAL - EAR (OPP) 1020 1020 1330 1530 1740 1940 SVC002276 FOREIGN BODY REMOVAL - NOSE (OPP) 1020 1020 1330 1530 1740 1940 SVC002277 FOREIGN BODY REMOVAL - THROAT (OPP) 1020 1020 1330 1530 1740 1940 SVC002278 KELOID EXCISION - PINNA 2200 2200 2860 3300 3740 4180 SVC002279 INCISION AND DRAINAGE -EAR HAEMATOMA 2810 3650 4210 4770 5330 SVC002282 NASAL CAUTERIZATION 7210 9370 10810 12250 13690 SVC002283 FACIAL NERVE DECOMPRESSION 49500 64350 74250 84150 94050 SVC002285 ENDOSCOPIC DACROCYSTORHINOSTOMY (DCR) 16940 16940 22020 25410 28800 32190 SVC002286 CSF OTORRHOEA CLOSURE 32340 32340 42040 48510 54980 61450 SVC002287 ENDOSCOPIC CSF CLOSURE 32340 32340 42040 48510 54980 61450 SVC002289 FOREIGN BODY REMOVAL - EAR 3140 4080 4700 5330 5960 SVC002290 FOREIGN BODY REMOVAL - NOSE 3450 3450 4490 5180 5870 6560 SVC002292 EPLEY MANEUVER 550 550 720 830 940 1050 SVC002293 EXCISION OF RANULA 11000 14300 16500 18700 20900 SVC002295 OTOACOUSTIC EMISSIONS (OAE) 880 880 1140 1320 1500 1670 SVC002297 SYRINGING OF EAR (ONE SIDE) 280 280 360 410 470 520 SVC002298 SUCTIONING OF EAR 140 140 190 210 240 270 SVC002308 EAR PIERCING WITH GUN (SINGLE)_GST 880 880 1140 1320 1500 1670 SVC002309 EAR PIERCING WITH GUN (BOTH)_GST 1710 1710 2220 2560 2900 3240 SVC002310 OTOENDOSCOPY 830 830 1070 1240 1400 1570 SVC002311 EAR WAX REMOVAL U/L 420 420 540 630 710 790 SVC002313 I & D - PERITONSILLAR ABSCESS 1100 1100 1430 1650 1870 2090 SVC002318 THYROGLOSSAL CYST EXCISION 17600 22880 26400 29920 33440 SVC002319 BRANCHIAL FISTULA / CYST EXCISION 10010 13010 15020 17020 19020 SVC002323 DIRECT LARYNGOSCOPY AND BIOPSY 5500 7150 8250 9350 10450 SVC002324 EXPLORATORY TYMPANOTOMY 21780 28310 32670 37030 41380 SVC002325 NOSE PIERCING_GST 970 970 1260 1450 1650 1840 SVC002331 BERA/AEP (BRAIN STEM AUDITORY EVOKED POTENTIALS 4400 5720 6600 7480 8360 SVC002335 MYRINGOPLASTY 20790 27030 31190 35340 39500 SVC002336 MYRINGOTOMY 2730 3550 4100 4640 5190 SVC002339 SHORT INCREAMENT SENSITIVITY INDEX - (SISI) 1050 1050 1370 1580 1790 2000 SVC002343 SUBMANDIBULAR GLAND EXCISION 22440 29170 33660 38150 42640 SVC002345 COCHLEAR IMPLANT 53680 69780 80520 91260 101990 SVC002353 MICROLARYNGOSCOPY BIOPSY 11000 11000 14300 16500 18700 20900 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC002359 GLOMUS TUMOR EXCISION 62590 81370 93890 106400 118920 SVC002381 FESS WITH SEPTOPLASTY & TURBINECTOMY OR POLYPECTOMY- UNILATERAL 16500 21450 24750 28050 31350 SVC002382 FESS WITH SEPTOPLASTY & TURBINECTOMY OR POLYPECTOMY- BILATERAL 26400 34320 39600 44880 50160 SVC011541 SPEECH THERAPY (ASSESSMENT) 840 840 1090 1260 1430 1600 SVC011542 SPEECH THERAPY (10 SESSION PACKAGE - 30 MINUTES EACH) 6600 6600 8580 9900 11220 12540 SVC011543 HEARING AID PROGRAMMING 1100 1100 1430 1650 1870 2090 SVC011544 HYPERACCUSIS RE-TRAINING THERAPY (TRT) - PER SESSION 660 660 860 990 1120 1250 SVC011545 ABLB TEST 1100 1100 1430 1650 1870 2090 SVC011951 FIBRE OPTIC LARYNGOSCOPY_ THERAPEUTIC 3300 3300 4290 4950 5610 6270 SVC011952 FIBRE OPTIC LARYNGOSCOPY DIAGNOSTIC 1650 1650 2150 2480 2810 3140 Gastroenterology PKG003910 COLONOSCOPY AHD PKG 8710 11330 13070 14810 16550 PKG003911 SIGMOIDOSCOPY AHD PKG 6050 7870 9080 10290 11500 PKG003913 ACHALASIA DILATATION PKG 11550 15020 17330 19640 21950 PKG003919 OESOPHAGO GASTRO DUODENOSCOPY (ENDOSCOPY) AHD PKG 6050 7870 9080 10290 11500 PKG003923 ERCP SPHINCTEROTROMY BALOON SWEEP_PKG 22000 28600 33000 37400 41800 PKG003924 ERCP STENT REMOVAL_PKG 20570 26740 30860 34970 39080 PKG006424 ENTEROSCOPY PKG 8800 11440 13200 14960 16720 PKG006425 ERCP - DIAGNOSTIC PKG 17050 22170 25580 28990 32400 PKG006430 ERCP SPHINCTEROTROMY _PKG 20350 26460 30530 34600 38670 PKG006442 LIVER BIOPSY - PERCUTANEOUS PKG 7150 9300 10730 12160 13590 PKG006446 COLONOSCOPY WITH ARGON PLASMA COAGULATION PKG 13200 17160 19800 22440 25080 PKG006447 ENDOSCOPIC (GASTRO) FOREIGN BODY REMOVAL PKG 11500 14940 17240 19540 21840 PKG014729 ERCP + STONE REMOVAL - WITH LITHOTRIPSY PKG 27720 36040 41580 47120 52670 PKG014731 ERCP + BILIARY STENTING PKG 22000 28600 33000 37400 41800 PKG014732 ERCP + BILIARY STENTING + STONE REMOVAL PKG 26620 34610 39930 45250 50580 PKG014733 SIDE VIEWING ENDOSCOPY PKG 9350 12160 14030 15900 17770 PKG014734 PEG BUTTON / PEG BALLOON PLACEMENT PKG 9900 12870 14850 16830 18810 PKG014735 ENDOSCOPIC BALLOON DILATATION - SUBSEQUENT SESSION WITHIN 1 MONTH PKG 8250 10730 12380 14030 15680 PKG014736 ENTERAL STENTING PKG 19800 25740 29700 33660 37620 PKG014737 ERCP + PANCREATIC STENTING PKG 22000 28600 33000 37400 41800 PKG014738 OESOPHAGEAL DILATATION - BOUGIE PKG 9900 12870 14850 16830 18810 PKG014739 ENDOSCOPIC BALLOON DILATATION PKG 11000 14300 16500 18700 20900 PKG014740 THERAPEUTIC ENDOSCOPY PKG 7700 10010 11550 13090 14630 PKG014741 APC PKG 10450 13590 15680 17770 19860 PKG014742 ENDOSCOPIC PLACEMENT OF INTRAGASTRIC BALLOON.PKG 11000 14300 16500 18700 20900 SVC002817 CAPSULE ENDOSCOPY 17050 17050 22170 25580 28990 32400 SVC002818 COLONOSCOPY 7760 7760 10090 11640 13190 14740 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC002819 ENDOSCOPIC BALLOON DILATATION 9350 9350 12160 14030 15900 17770 SVC002821 SIGMOIDOSCOPY 4700 4700 6110 7050 7990 8930 SVC002822 POLYPECTOMY 3900 5100 5900 6700 7500 SVC002823 ACHALASIA DILATATION 11000 14300 16500 18700 20900 SVC002827 ENDOSCOPIC BALLOON DILATATION - SUBSEQUENT SESSION WITHIN 1 MONTH 6600 6600 8580 9900 11220 12540 SVC002829 ENDOSCOPIC CLIP APPLICATION 3300 3300 4290 4950 5610 6270 SVC002833 ENDOSCOPIC PSEUDOCYST DRAINAGE 21780 28310 32670 37030 41380 SVC002834 ENDOSCOPIC VARICEAL LIGATION - SUBSEQUENT SESSION WITHIN 1 MONTH 5940 5940 7720 8910 10100 11290 SVC002836 ENTEROSCOPY 6930 6930 9010 10400 11780 13170 SVC002837 ERCP - DIAGNOSTIC 14080 18300 21120 23940 26750 SVC002838 ERCP + BILIARY STENTING 19030 24740 28550 32350 36160 SVC002839 ERCP + PANCREATIC STENTING 19030 24740 28550 32350 36160 SVC002840 ERCP + SPHINCTEROTOMY 17380 22590 26070 29550 33020 SVC002841 ERCP + STONE REMOVAL - WITHOUT LITHOTRIPSY 18590 24170 27890 31600 35320 SVC002842 OESOPHAGEAL DILATATION - BOUGIE 8250 8250 10730 12380 14030 15680 SVC002844 ESOPHAGEAL STENTING 19800 25800 29700 33700 37700 SVC002848 OESOPHAGO GASTRO DUODENOSCOPY (ENDOSCOPY) 4940 4940 6420 7410 8400 9390 SVC002849 PEG BUTTON / PEG BALLOON PLACEMENT 11090 14420 16640 18850 21070 SVC002850 PERCUTANEOUS ENDOSCOPIC JEJUNOSTOMY 12540 16300 18810 21320 23830 SVC002851 PYLORIC DILATATION (FIRST SESSION) 6050 6050 7870 9080 10290 11500 SVC002853 SENGSTAKEN TUBE INSERTION 8250 8250 10730 12380 14030 15680 SVC002854 APC - FIRST SESSION 8420 8420 10940 12620 14310 15990 SVC002856 CHROMOENDOSCOPY 5120 5120 6650 7670 8700 9720 SVC002861 ENDOSCOPIC POLYPECTOMY - MULTIPLE 14300 18590 21450 24310 27170 SVC002867 ENTERAL STENTING 16830 21880 25250 28610 31980 SVC002870 LIVER BIOPSY - PERCUTANEOUS 6600 6600 8580 9900 11220 12540 SVC002874 PERCUTANEOUS ENDOSCOPIC GASTROTOMY REMOVAL 3300 3300 4290 4950 5610 6270 SVC002875 PUSH ENTEROSCOPY 6490 6490 8440 9740 11030 12330 SVC002876 ERCP + STONE REMOVAL - WITH LITHOTRIPSY 24750 32180 37130 42080 47030 SVC002883 COLONOSCOPY WITH ARGON PLASMA COAGULATION 11330 14730 17000 19260 21530 SVC002884 ENDOSCOPIC BIOPSY 710 710 920 1070 1210 1350 SVC002886 ENDOSCOPIC (GASTRO) FOREIGN BODY REMOVAL 8800 8800 11440 13200 14960 16720 SVC002889 LOOP COLOSTOMY 23210 30170 34820 39460 44100 SVC002896 LARGE VOLUME PARACENTESIS 4400 4400 5720 6600 7480 8360 SVC002897 UMBILICAL HERNIOPLASTY 18700 24310 28050 31790 35530 SVC002903 RADICAL HEMICOLECTOMY 46200 60060 69300 78540 87780 SVC002906 PROCTOSCOPY 1780 1780 2320 2670 3030 3390 SVC002907 SIDE VIEWING ENDOSCOPY 7660 7660 9950 11480 13020 14550 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC002910 ERCP STENT REMOVAL 15730 20450 23600 26740 29890 SVC002919 HEPATIC VENOUS PRESSURE GRADIENT (HVPG) 8800 8800 11440 13200 14960 16720 SVC002922 ERCP + BILIARY STENTING + STONE REMOVAL 25480 33120 38210 43310 48400 SVC002929 PILES BANDING 1470 1470 1920 2210 2510 2800 SVC002937 EUS (ENDOSCOPIC ULTRASOUND) GUIDED FNA OF PANCREATIC MASS 15070 19590 22610 25620 28630 SVC002945 ARGON PLASMA COAGULATION (APC) 8800 11440 13200 14960 16720 SVC002946 PEG (PERCUTANEOUS ENDOSCOPIC GASTROSTOMY) TUBE REMOVAL 3960 5150 5940 6730 7520 SVC002968 ENDOSCOPY (BED SIDE) 2960 3850 4440 5030 5620 SVC002969 THERAPEUTIC ENDOSCOPY 7180 7180 9340 10770 12210 13650 SVC002970 DIAGNOSTIC PARACENTESIS 2200 2200 2860 3300 3740 4180 SVC002971 ERCP SPHINCTEROTROMY BALOON SWEEP 19030 24740 28550 32350 36160 SVC002972 ENDOSCOPIC PLACEMENT OF INTRAGASTRIC BALLOON. 9350 12160 14030 15900 17770 SVC002977 CHOLECYSTECTOMY & EXPLORATION + REPAIR OF COMMON BILE DUCT 30800 40040 46200 52360 58520 SVC003039 ESOPHAGEAL BRUSH CYTOLOGY 1100 1650 2145 2475 2805 3135 General Surgery PKG003324 LYMPH NODE BIOPSY PKG 11660 15160 17490 19820 22150 PKG003780 FISTULOTOMY WITH SETON PLACEMENT (HIGH) PKG 66550 86520 99830 113140 126450 PKG004517 LIVER TRANSPLANT (RECIPIENT) - A PKG 1600000 1600000 1600000 1900000 1900000 PKG004518 LIVER TRANSPLANT (RECIPIENT) - B PKG 1900000 1900000 1900000 2500000 2500000 PKG006391 HAEMORROIDECTOMY/ PILES PKG 57480 74720 86210 97710 109200 PKG014718 LAPROSCOPIC CHOLECYSTECTOMY PKG 66550 86520 99830 113140 126450 PKG014724 SPECIAL UMBILICAL HERNIA REPAIR PKG 55000 71500 82500 93500 104500 SVC002405 OPEN ADRENALECTOMY 35800 46600 53700 60900 68100 SVC002407 ANTERIOR RESECTION (OPEN) 39600 51480 59400 67320 75240 SVC002408 CAPD CATHETER INSERTION 16000 20800 24000 27200 30400 SVC002411 CHOLEDOCHAL CYST EXCISION WITH HEPATICOJEJUNOSTOMY (OPEN) 33000 42900 49500 56100 62700 SVC002414 ENUCLEATION OF BENIGN PANCREATIC NEOPLASM / CYST 30000 39000 45000 51000 57000 SVC002415 EXCISION OF MESENTERIC MASS (OPEN) 15000 19500 22500 25500 28500 SVC002416 EXCISION OF SEBACEOUS CYST 4620 6010 6930 7850 8780 SVC002417 EXTRAPERITONEAL DRAINAGE OF PSOAS ABSCESS / RETROPERITONEAL ABSCESS 15400 20020 23100 26180 29260 SVC002419 FISTULOTOMY WITH SETON PLACEMENT (HIGH) 22000 28600 33000 37400 41800 SVC002421 GASTRO JEJUNOSTOMY + VAGOTOMY (OPEN) 26000 33800 39000 44200 49400 SVC002423 HEPATECTOMY 38500 50050 57750 65450 73150 SVC002424 HILAR CHOLANGIOCARCINOMA RESECTION 48000 62400 72000 81600 91200 SVC002425 HOLLOW VISCUS PERFORATION CLOSURE (OPEN) 15000 19500 22500 25500 28500 SVC002427 ILEOSTOMY / COLOSTOMY CLOSURE 19800 25740 29700 33660 37620 SVC002430 LAPAROSCOPIC ANTERIOR RESECTION 44400 57720 66600 75480 84360 SVC002433 LAPAROSCOPIC CHOLECYSTECTOMY WITH LAPAROSCOPIC CBD EXPLORATION 35000 45500 52500 59500 66500 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC002434 LAPAROSCOPIC DISTAL PANCREATECTOMY WITH SPLENECTOMY 50000 65000 75000 85000 95000 SVC002435 LAPAROSCOPIC DUODENAL PERFORATION CLOSURE 24000 31200 36000 40800 45600 SVC002436 LAPAROSCOPIC GASTROJEJUNOSTOMY + VAGOTOMY 35000 45500 52500 59500 66500 SVC002438 LAPAROSCOPIC HYDATID CYST EXCISION 35000 45500 52500 59500 66500 SVC002439 LAPAROSCOPIC INGUINAL HERNIA REPAIR (TEP) BILATERAL 25000 32500 37500 42500 47500 SVC002440 LAPAROSCOPIC LIVER ABSCESS DRAINAGE 24000 31200 36000 40800 45600 SVC002442 LAPAROSCOPIC OVARIAN DRILLING 15900 20700 23900 27100 30300 SVC002443 LAPAROSCOPIC PANCREATIC NECROSECTOMY 40000 52000 60000 68000 76000 SVC002444 LAPAROSCOPIC PARTIAL GASTRECTOMY 30000 39000 45000 51000 57000 SVC002446 LAPAROSCOPIC RECTOPEXY 24000 31200 36000 40800 45600 SVC002447 LATERAL ANAL SPHINCTEROTOMY 9200 12000 13800 15700 17500 SVC002449 LORD'S PROCEDURE 3500 4550 5250 5950 6650 SVC002450 MESOCAVAL SHUNT 28000 36400 42000 47600 53200 SVC002452 OPEN ADHESIOLYSIS 14300 18600 21500 24400 27200 SVC002453 OPEN APPENDICECTOMY 14000 18200 21000 23800 26600 SVC002455 PANCREATIC NECROSECTOMY (OPEN) 35000 45500 52500 59500 66500 SVC002456 PARTIAL GASTRECTOMY (OPEN) 22000 28600 33000 37400 41800 SVC002457 PILONIDAL SINUS EXCISION 12000 15600 18000 20400 22800 SVC002460 RADICAL GASTRECTOMY (OPEN) 30000 39000 45000 51000 57000 SVC002465 OPEN SMALL BOWEL RESECTION 16500 21450 24750 28050 31350 SVC002467 SPLENECTOMY (OPEN) 22000 28600 33000 37400 41800 SVC002468 STAPLED HEMORRHOIDECTOMY 19800 25740 29700 33660 37620 SVC002470 TOTAL OESOPHAGECTOMY WITH GASTRIC PULLUP 50000 65000 75000 85000 95000 SVC002471 TOTAL PROCTOCOLECTOMY WITH ILEOANAL POUCH 30000 39000 45000 51000 57000 SVC002472 TRANSANAL EXCISION OF RECTAL TUMOR / POLYP 10000 13000 15000 17000 19000 SVC002476 CHOLEDOCHODUODENOSTOMY 25000 32500 37500 42500 47500 SVC002478 OPEN CHOLECYSTECTOMY 18000 23400 27000 30600 34200 SVC002479 PILONIDAL SINUS EXCISION WITH ROTATION FLAP COVER 22000 28600 33000 37400 41800 SVC002484 INCISIONAL HERNIA REPAIR (OPEN) 17000 22100 25500 28900 32300 SVC002487 PANCREATICO -JEJUNOSTOMY 32000 41600 48000 54400 60800 SVC002488 TOTAL THYROIDECTOMY WITH NECK DISSECTION 38500 50050 57750 65450 73150 SVC002489 COLONOSCOPY POLYPECTOMY 11600 15080 17400 19720 22040 SVC002494 HEPATICOJEJUNOSTOMY 28000 36400 42000 47600 53200 SVC002495 LAPAROSCOPIC TOTAL PROCTOCOLECTOMY WITH ILEOSTOMY 44000 57200 66000 74800 83600 SVC002496 DIVERSION TRANSVERSE COLOSTOMY 26700 34800 40100 45400 50800 SVC002498 DEEP SUTURING 1450 1890 2180 2470 2760 SVC002499 DEEP WOUND DEBRRIDEMENT 8500 11100 12800 14500 16200 SVC002500 SUPERFICIAL INCISION AND DRAINAGE 2420 2420 3150 3630 4110 4600 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC002501 SUPERFICIAL SUTURING 1160 1160 1510 1740 1970 2200 SVC002502 SUPERFICIAL WOUND DEBRRIDEMENT 3300 3300 4290 4950 5610 6270 SVC002504 INGUINAL HERNIOPLASTY (UNILATERAL) 16000 20800 24000 27200 30400 SVC002505 CYSTOGASTROSTOMY/CYSTOJEJUNOSTOMY(OPEN) 22000 28600 33000 37400 41800 SVC002506 DIAPHRAGMATIC HERNIA REPAIR(OPEN) 21000 27300 31500 35700 39900 SVC002507 FUNDOPLICATION(OPEN) 28000 36400 42000 47600 53200 SVC002508 HYDATID CYSTOPERICYSTECTOMY (OPEN) 30800 40040 46200 52360 58520 SVC002509 LAPAROSCOPIC RETROPERITONEAL LYMPH NODE BIOPSY 14000 18200 21000 23800 26600 SVC002511 REPAIR OF RECTO VAGINAL/RECTO VESICAL FISTULA 26000 33800 39000 44200 49400 SVC002512 INGUINAL HERNIOPLASTY (BILATERAL) 20000 26000 30000 34000 38000 SVC002513 CHOLECYSTECTOMY WITH CHOLEDOCHODUODENOSTOMY 22000 28600 33000 37400 41800 SVC002514 LAPAROSCOPIC DIAPHRAGMATIC HERNIA REPAIR 25000 32500 37500 42500 47500 SVC002517 LAPAROSCOPIC NEPHRECTOMY 30000 39000 45000 51000 57000 SVC002518 RADICAL CHOLECYSTECTOMY 52800 68640 79200 89760 100320 SVC002520 HEMORRHOIDS BANDING 3500 4600 5300 6000 6700 SVC002521 LAPAROSCOPIC CHOLEDOCHAL CYST EXCISION WITH HEPATICOJEJUNOSTOMY 40000 52000 60000 68000 76000 SVC002524 LAPAROSCOPIC EXTENDED HEMICOLECTOMY 30000 39000 45000 51000 57000 SVC002526 DRAINAGE OF PERIANAL ABSCESS 7440 9670 11160 12650 14140 SVC002528 TRIPLE BYPASS (CA PANCREAS) 37300 48500 56000 63500 70900 SVC002532 COMMON BILE DUCT (CBD) EXPLORATION 23700 30810 35550 40290 45030 SVC002533 LAPAROSCOPIC APPENDICECTOMY 20300 26400 30500 34600 38600 SVC002534 LAPAROSCOPIC CHOLECYSTECTOMY (SIMPLE) 20000 26000 30000 34000 38000 SVC002535 LAPAROSCOPIC INGUINAL HERNIA REPAIR (TEP) UNILATERAL 20000 26000 30000 34000 38000 SVC002536 OPEN HEMORRHOIDECTOMY 11000 14300 16500 18700 20900 SVC002537 FISTULECTOMY (LOW) 12000 15600 18000 20400 22800 SVC002538 DIAGNOSTIC LAPAROSCOPY 19800 25740 29700 33660 37620 SVC002543 EXPLORATORY LAPAROTOMY (LIVER TRAUMA) 24000 31200 36000 40800 45600 SVC002544 ILEOSTOMY / COLOSTOMY DIVERSION 23760 30890 35640 40400 45150 SVC002545 FUNDOPLICATION(LAPAROSCOPIC) 28000 36400 42000 47600 53200 SVC002547 GASTROJEJUNOSTOMY OPEN 20000 26000 30000 34000 38000 SVC002548 GASTROJEJUNOSTOMY LAPAROSCOPIC 25000 32500 37500 42500 47500 SVC002549 PARAUMBILICAL HERNIA REPAIR (LAPAROSCOPIC) 17000 22100 25500 28900 32300 SVC002551 ADHESIOLYSIS LAPAROSCOPIC 17050 22170 25580 28990 32400 SVC002552 BURST ABDOMEN/LAPAROTOMY WOUND RESUTURING 15000 19500 22500 25500 28500 SVC002553 EXPLORATORY LAPAROTOMY WITH LAVAGE 21120 27460 31680 35910 40130 SVC002554 RETROPERITONEAL MASS EXCISION 25000 32500 37500 42500 47500 SVC002555 PANCREATICO - DUODENECTOMY (WHIPPLE'S) 55000 71500 82500 93500 104500 SVC002556 CYSTOGASTROSTOMY/CYSTOJEJUNOSTOMY(LAPAROSCOPIC) 30000 39000 45000 51000 57000 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC002557 SPLENECTOMY (LAPAROSCOPIC) 25000 32500 37500 42500 47500 SVC002563 DEBULKING OF TUMOUR 50000 65000 75000 85000 95000 SVC002564 LAPAROSCOPIC VAULT SUSPENSION 26500 34450 39750 45050 50350 SVC002565 WOUND DEBRIDEMENT - SMALL 3780 3780 4910 5670 6430 7180 SVC002567 HAEMORROIDECTOMY/ PILES 18000 23400 27000 30600 34200 SVC002568 LUMP (SMALL) 5780 7510 8670 9830 10980 SVC002569 LUMP (MEDIUM) 8670 11270 13010 14740 16470 SVC002570 LUMP (LARGE) 10500 13650 15750 17850 19950 SVC002575 REMOVAL OF INFECTED MESH 23000 29900 34500 39100 43700 SVC002578 EXCISION OF CORN - MULTIPLE 2000 2600 3000 3400 3800 SVC002582 LAPCHOLECYSTECTOMY WITH APPENDISECTOMY 36000 46800 54000 61200 68400 SVC002583 LARGE INCISIONAL/VENTRAL HERNIA REPAIR 22440 22440 29180 33660 38150 42640 SVC002584 DISTAL /TOTAL GASTRECTOMY 30000 30000 39000 45000 51000 57000 SVC002588 ABDOMINOPLASTY_GST 39200 51000 58800 66700 74500 SVC002591 MANAGEMENT OF PERFORATION PERITONITIS 36000 36000 46800 54000 61200 68400 SVC002593 INCISION & DRAINAGE - MAJOR 6600 6600 8580 9900 11220 12540 SVC002594 INCISION & DRAINAGE - MINOR 4940 4940 6420 7410 8400 9390 SVC002597 LIVER RESECTION ( OPEN) 49500 64350 74250 84150 94050 SVC002598 ABDOMINO PERINEAL RESECTION 32000 41600 48000 54400 60800 SVC002602 DIAGNOSTIC ENDOSCOPIC ULTRASOUND 17430 17430 22660 26150 29640 33120 SVC002604 NAIL BED EXCISION 3850 3850 5010 5780 6550 7320 SVC002605 EXCISION OF CORN- SINGLE 3300 3300 4290 4950 5610 6270 SVC002606 PARAPHIMOSIS REDUCTION 4200 5460 6300 7140 7980 SVC002609 FOURNIER GANGRENE 17000 22100 25500 28900 32300 SVC002614 FISSURECTOMY 14790 19230 22190 25150 28110 SVC002626 VIDEOASSISTED ANAL FISTULA TREATMENT (VAAFT) 25000 32500 37500 42500 47500 SVC002632 PORTOCAVAL ANASTOMOSIS 25000 32500 37500 42500 47500 SVC002639 LAPAROSCOPIC BARIATRIC SURGERY GASTRIC BYPASS_NON GST 36000 46800 54000 61200 68400 SVC002640 LAPAROSCOPIC BARIATRIC SURGERY SLEEVE GASTRECTOMY_NON GST 43200 56160 64800 73440 82080 SVC002642 LAPAROSCOPIC CAPD CATHETER INSERTION 25000 32500 37500 42500 47500 SVC002649 LAPAROSCOPIC URETERIC RE IMPLANTATION((BILATERAL) 70000 91000 105000 119000 133000 SVC002651 COMMON BILE DUCT REPAIR 32000 41600 48000 54400 60800 SVC002657 FISTULA IN ANO-HIGH LEVEL 15000 19500 22500 25500 28500 SVC002658 LAP/OPEN VENTRAL/ EPIGASTRIC/ UMBLICAL HERNIA- SMALL 22440 29180 33660 38150 42640 SVC002659 TUBE CEACOSTOMY 7000 9100 10500 11900 13300 SVC002660 UMBILECTOMY 10000 13000 15000 17000 19000 SVC002661 WOUND DELAYED SUTURING 12000 15600 18000 20400 22800 SVC002662 WOUND GUN-SHOT DEBRIDEMENT 12000 15600 18000 20400 22800 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC002663 ABSCESS DRAINAGE SUB-DIAPRAGMAPHIC/SUB-HEPATIC 15000 19500 22500 25500 28500 SVC002664 LAP/OPEN VENTRAL/EPIGASTRIC/UMBLICAL HERNIA IRREDUCIBLE 33000 42900 49500 56100 62700 SVC002665 HERNIOTOMY-OPEN/LAP 12000 15600 18000 20400 22800 SVC002666 ISCHIORECTAL ABSCESS 10000 13000 15000 17000 19000 SVC002670 APPENDICULAR ABSCESS DRAINAGE 10000 13000 15000 17000 19000 SVC002671 LAP APPENDICULAR ABSCESS DRAINAGE 13000 16900 19500 22100 24700 SVC002672 UMBILICAL SINUS EXCISION 20000 26000 30000 34000 38000 SVC002674 STAGING LAPAROSCOPY 35000 45500 52500 59500 66500 SVC002675 LAPAROSCOPIC INTESTINAL INTER LOOP ADHESIOLYSIS 33600 43680 50400 57120 63840 SVC002698 INTUSSUSCEPTION 17000 22100 25500 28900 32300 SVC002708 RESECTION ANASTOMOSIS (LARGE INTESTINE) 35000 45500 52500 59500 66500 SVC002727 CLOSURE OF HOLLOW VISCUS PERFORATION 24000 31200 36000 40800 45600 SVC002809 LAPROSCOPIC CYSTOPROSTATECTOMY 65000 84500 97500 110500 123500 SVC002810 LAPAROSCOPY DIVERSION OF INTESTINAL BAND 30000 39000 45000 51000 57000 SVC002811 CLOSURE OF CHOLECYSTO-DUAODENAL FISTULA 24000 31200 36000 40800 45600 SVC003025 EUS DIAGNOSTIC 6830 6830 8880 10250 11620 12980 SVC003117 LAPAROSCOPIC OVARIAN CYSTECTOMY 22000 28600 33000 37400 41800 SVC007806 LAPAROSCOPIC HELLER'S CARDIOMYOTOMY 33000 42900 49500 56100 62700 SVC007942 LAPROSCOPIC CHOLEDOCHO DUODENOSTOMY 27500 35750 41250 46750 52250 SVC007964 LAPROSCOPIC CORRECTION OF MALROTATION OF GUT 35000 45500 52500 59500 66500 SVC010655 TRANSHIATAL OESOPHAGECTOMY (THE) 55000 71500 82500 93500 104500 SVC011619 SPLENECTOMY & ESOPHAGO GASTIC DEVASCULARISATION 65000 84500 97500 110500 123500 SVC011689 ILEAL RESECTION INCLUDING TUMOR SEGMENT AND DOUBLE BARREL ILEOSTOMY 23000 29900 34500 39100 43700 SVC011893 Lapcecopexy 30000 39000 45000 51000 57000 SVC011894 INTERNAL HERNIA WITH MALROTATION OF GUT 33000 42900 49500 56100 62700 SVC012877 LAPAROSCOPIC PARTIAL SPLENECTOMY 11600 15100 17400 19800 22100 SVC012916 SEGMENTAL COLECTOMY 22000 28600 33000 37400 41800 Gynecology PKG002993 FISTULECTOMY (LOW) PKG 38500 50050 57750 65450 73150 PKG003875 LAPAROSCOPIC CHOLECYSTECTOMY (SIMPLE)-GRADE B PKG 100790 131030 151190 171350 191510 PKG003880 LAPAROSCOPIC INGUINAL HERNIA REPAIR UNILATERAL 60500 78650 90750 102850 114950 PKG003974 LAPAROSCOPIC ASSISTED VAGINAL HYSTERECTOMY PKG 115500 150150 173250 196350 219450 PKG003985 ABDOMINAL HYSTERECTOMY PKG 99000 128700 148500 168300 188100 PKG004590 CIRCUMCISION PKG 26620 34610 39930 45250 50580 PKG006340 LAPAROSCOPIC APPENDICECTOMY PKG 66550 86520 99830 113140 126450 PKG006487 DILATION & CURETTAGE PKG 12650 16450 18980 21510 24040 PKG006527 DILATATION AND CURETTAGE DIAGNOSTIC PKG 11000 14300 16500 18700 20900 PKG008567 DIAGNOSTIC HYSTEROSCOPY PKG 41250 53630 61880 70130 78380 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite PKG008984 LAPAROSCOPIC INGUINAL HERNIA REPAIR B/L (TEP) PKG 79260 103030 118880 134730 150580 PKG014806 Merina Insertion Level I Pkg 5800 7540 8700 9860 11020 SVC003041 BARTHOLINS ABSCESS DRAINAGE 7210 9370 10810 12250 13690 SVC003044 CRYOSURGERY 3740 4860 5610 6360 7110 SVC003045 DELIVERY WITHOUT EPIDURAL 11110 14440 16670 18890 21110 SVC003047 DILATATION AND CURETTAGE 14300 18590 21450 24310 27170 SVC003049 FRACTIONAL CURETTAGE 7150 9300 10730 12160 13590 SVC003050 HYSTEROTOMY 22440 29170 33660 38150 42640 SVC003051 INSERTION OF INTRAUTERINE CONTRACEPTIVE DEVICE 3080 4000 4620 5240 5850 SVC003052 INTRA UTERINE INSEMINATION 3470 4500 5200 5890 6580 SVC003053 LAPAROSCOPIC ASSISTED VAGINAL HYSTERECTOMY 46200 60060 69300 78540 87780 SVC003058 REMOVAL OF INTRAUTERINE CONTRACEPTIVE DEVICE 2370 3080 3560 4030 4500 SVC003059 STAGING LAPAROTOMY- TAH WITH BSO WITH RPLND WITH OMENTECTOMY 30690 39900 46040 52170 58310 SVC003060 TOTAL ABDOMINAL HYSTERECTOMY 49500 64350 74250 84150 94050 SVC003061 WERTHEIM'S HYSTERECTOMY 72400 94120 108600 123080 137560 SVC003062 NST (NON STRESS TEST) 890 890 1160 1340 1510 1690 SVC003063 BREECH DELIVERY 18700 24310 28050 31790 35530 SVC003064 COLPOSCOPY OF CERVIX 4600 5980 6900 7820 8740 SVC003068 ANTERIOR COLPORRHAPHY 10780 14010 16170 18330 20480 SVC003069 BURCH COLPOSUSPENSION 25080 32600 37620 42640 47650 SVC003071 CERVICAL POLYPECTOMY - LARGE 6220 8080 9320 10570 11810 SVC003073 CESAREAN HYSTERECTOMY 7400 9620 11100 12580 14060 SVC003075 COLPOSCOPY OF VULVA 3910 5080 5860 6640 7420 SVC003076 CONE BIOPSY 5400 7020 8100 9180 10260 SVC003078 DILATATION AND CURETTAGE DIAGNOSTIC 3300 4300 4950 5600 6300 SVC003081 HYSTERECTOMY 8140 10580 12210 13840 15470 SVC003083 HYSTEROSCOPIC ENDOMETRIAL ABLATION 13800 17940 20700 23460 26220 SVC003084 HYSTEROSCOPIC MYOMECTOMY 13090 17020 19640 22250 24870 SVC003085 HYSTEROSCOPIC SEPTAL RESECTION 25080 32600 37620 42640 47650 SVC003086 HYSTEROSCOPY DIAGNOSTIC 11000 14300 16500 18700 20900 SVC003087 HYSTEROSCOPY POLYPECTOMY 25200 32760 37800 42840 47880 SVC003090 LAPAROSCOPIC GONADECTOMY / SALPINGO OOPHORECTOMY 34430 44760 51650 58530 65420 SVC003091 LAPAROSCOPIC MYOMECTOMY 20790 27030 31190 35340 39500 SVC003094 LAPAROSCOPIC SURGERY FOR ECTOPIC PREGNANCY (SALPINGECTOMY/ SALPINGOTOMY)21560 28030 32340 36650 40960 SVC003097 PYOMETRA DRAINAGE 5940 7720 8910 10100 11290 SVC003098 RECTO VAGINAL FISTULA REPAIR 14630 19020 21950 24870 27800 SVC003102 SLING OPERATION (KHANNAS / PURANDARES / SHIRODKARS) 21780 28310 32670 37030 41380 SVC003106 INTERVAL TUBECTOMY 10450 13590 15680 17770 19860 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003109 VAGINAL HYSTERECTOMY WITH PELVIC FLOOR REPAIR 55880 72640 83820 95000 106170 SVC003110 VAGINOPLASTY 34320 44620 51480 58340 65210 SVC003112 VESICOVAGINAL FISTULA REPAIR 35860 46620 53790 60960 68130 SVC003116 ENDOMETRIAL BIOPSY 5250 6800 7800 9000 9900 SVC003118 LARGE LOOP EXCISION OF TRANSFORMATION ZONE OF CERVIX (LLETZ/LEEP) 13750 17880 20630 23380 26130 SVC003119 OMENTECTOMY 24200 31460 36300 41140 45980 SVC003120 COUNSELLING - MEDICAL TERMINATION OF PREGNANCY 1380 1380 1790 2060 2340 2610 SVC003125 SPONTANEOUS ABORTION (SECOND TRIMESTER) 13200 17160 19800 22440 25080 SVC003126 SALPINGO OOPHRECTOMY ( OPEN) 24310 31600 36470 41330 46190 SVC003129 EXCISION OF VULVAL MASS LESION 14630 19020 21950 24870 27800 SVC003133 SECOND LOOK LAPAROTOMY CYTOREDUCTIVE STUDY 40370 52480 60560 68630 76700 SVC003135 NON DESCENT VAGINAL HYSTERECTOMY 44770 58200 67160 76110 85060 SVC003146 LAMAZE SESSION 1 2200 2200 2860 3300 3740 4180 SVC003147 INTERNAL ILIAC ARTERY LIGATION - UNILATERAL 17600 22880 26400 29920 33440 SVC003148 INTERNAL ILIAC ARTERY LIGATION - BILATERAL 22000 28600 33000 37400 41800 SVC003156 BARTHOLIN CYST EXCISION 14520 18880 21780 24680 27590 SVC003159 STAGING LAPAROSCOPY WITH MULTIPLE BIOPSY WITH OOPHRECTOMY 46200 60060 69300 78540 87780 SVC003162 RADICAL VULVECTOMY 38170 49620 57260 64890 72520 SVC003163 STAGING LAPAROTOMY 19140 24880 28710 32540 36370 SVC012671 TOTAL LAPAROSCOPY HYSTERECTOMY + BILATRAL SALPINGO OPHERECTOMY + PELVIC LYMPHADENECTOMY80190 104250 120290 136320 152360 SVC012884 DIAGNOSTIC HYSTEROSCOPY 15510 20160 23270 26370 29470 SVC012891 HYDRO TUBATION 2200 2860 3300 3740 4180 SVC012897 LAPAROTOMY FOR PPH FOLLOWED BY INTERNAL ILLIAC LIGATION 7370 9580 11060 12530 14000 SVC012921 TRANS OBTURATOR TAPE(TOT ) 3520 4580 5280 5980 6690 Head & Neck Surgery SVC003196 FREE FLAP / RECONSTRUCTION 55000 71500 82500 93500 104500 SVC003199 ADVANCED NECK SURGERY (CAROTID BODY TUMOR, RADICAL NECK DISSECTION, NECK SCHWANOMA30800 ETC)40040 46200 52360 58520 SVC003200 PAROTIDECTOMY 30800 40040 46200 52360 58520 SVC003201 NECK DISSECTION 22000 28600 33000 37400 41800 SVC003202 LOCAL FLAP RECONSTRUCTION 16500 21450 24750 28050 31350 SVC003203 SUB MANDIBULAR GLAND EXCISION 17600 22880 26400 29920 33440 SVC003204 SUPERFICIAL PAROTIDECTOMY 22000 28600 33000 37400 41800 SVC003205 SKULL BASE SURGERY 49280 64060 73920 83780 93630 SVC003206 THYROPLASTY 32340 42040 48510 54980 61450 SVC003207 LARYNGECTOMY 43120 56060 64680 73300 81930 SVC003209 MAXILLECTOMY 46310 60200 69470 78730 87990 SVC003210 SURGICAL RE EXPLORATION 16500 21450 24750 28050 31350 SVC003215 LASER EXCISION (VOCAL CORD, ORAL CAVITY EXCISION, ETC) 27500 35750 41250 46750 52250 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003221 SPLIT SKIN GRAFTING MINOR 5450 7080 8170 9260 10350 SVC003222 SPLIT SKIN GRAFTING MAJOR 17420 22650 26140 29620 33110 SVC003229 BURNS CONTRACTURE RELEASE + MAJOR FLAP COVER 12650 16450 18980 21510 24040 SVC003233 TRACHO ESOPHAGEAL PROSTHESIS (TEP) INSERTION 11000 14300 16500 18700 20900 SVC003234 BILATERAL NECK DISSECTION 36410 47330 54620 61900 69180 SVC003235 ABDOMINOPLASTY MINOR_GST 27500 35750 41250 46750 52250 SVC003236 ABDOMINOPLASTY COMPLEX_GST 37400 48620 56100 63580 71060 SVC003239 DERMOID CYST EXCISION 12210 15870 18320 20760 23200 SVC003242 LIPOSUCTION SMALL AREA_GST 12100 15730 18150 20570 22990 SVC003243 LIPOSUCTION LARGE AREA_GST 29700 38610 44550 50490 56430 SVC003244 LIPOSCUTION MEDIUM AREA_GST 32230 41900 48350 54790 61240 SVC003245 FACE LIFT_GST 59950 77940 89930 101920 113910 SVC003247 UNILATERAL BREAST AUGMENTATION WITH IMPLANTS_GST 29700 38610 44550 50490 56430 SVC003248 UNILATERAL BREAST REDUCTION_GST 40920 53200 61380 69560 77750 SVC003251 HEMANGIOMA EXCISION MAJOR 15620 20310 23430 26550 29680 SVC003253 PARATHYROIDECTOMY 23650 30750 35480 40210 44940 SVC003254 PARATHYROIDECTOMY RADIOGUIDED 33000 42900 49500 56100 62700 SVC003274 NASAL ENDOSCOPY BIOPSY GA 3250 4250 4900 5550 6200 SVC003280 HEMIGLOSSECTOMY 45650 59350 68480 77610 86740 SVC003281 PARTIAL GLOSSECTOMY 19910 25880 29870 33850 37830 SVC003300 SUPERFICIAL PAROTIDECTOMY (COMPLEX) 38500 50050 57750 65450 73150 SVC003301 LIPOSUCTION SMALL AREA (COMPLEX) 17600 22880 26400 29920 33440 SVC003305 PECTORALIN MAJOR MYOCUTANIOUS FLAP (PMMC) 22000 28600 33000 37400 41800 SVC011624 TOTAL GLOSSECTOMY 22000 28600 33000 37400 41800 SVC011808 TOTAL MAXILLECTOMY 33000 42900 49500 56100 62700 SVC011958 TRACHEOESOPHAGEAL PROSTHESIS_ CHANGE 5500 7150 8250 9350 10450 SVC011959 NERVE GRAFTING 16500 21450 24750 28050 31350 SVC011960 MICROLARYNGOSCOPY EXCISION OF MASS SIMPLE 16500 21450 24750 28050 31350 SVC011961 MICROLARYNGOSCOPY EXCISION OF MASS COMPLEX 22000 28600 33000 37400 41800 Interventional Neurology PKG006662 VARICOSE VEINS EVT _PKG 71940 93520 107910 122300 136690 PKG008218 BELOW KNEE PLASTY _PKG 65340 84940 98010 111080 124150 SVC003357 BILIARY STENTING - 1 STENT 16500 21450 24750 28050 31350 SVC003416 SPINAL ANGIOGRAM MINOR 14300 18590 21450 24310 27170 SVC003417 SPINAL ANGIOGRAM MAJOR 19800 25740 29700 33660 37620 SVC003418 INTRACRANIAL ANGIOPLASTY 44000 57200 66000 74800 83600 SVC003419 INTRACRANIAL STENTING MAJOR 55660 72360 83490 94620 105750 SVC003421 ECA, SPINAL EMBOLISATION MINOR 33000 42900 49500 56100 62700 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003422 ECA, SPINAL EMBOLISATION MAJOR 55000 71500 82500 93500 104500 SVC003423 INTRACRANIAL AVM,DAVF EMBOLISATION MAJOR 39600 51480 59400 67320 75240 SVC003424 INTRACRANIAL AVM, DAVF EMBOLISATION SUPRAMAJOR 50000 65000 75000 85000 95000 SVC003425 COILING MAJOR 44000 57200 66000 74800 83600 SVC003426 COILING SUPRAMAJOR 55000 71500 82500 93500 104500 SVC003427 BALLOON TEST OCCLUSION 18700 24310 28050 31790 35530 SVC003428 CAROTID AND OTHER EXTRACRANIAL STENTING 59400 77220 89100 100980 112860 SVC003429 CHECK CEREBRAL ANGIOGRAM 6600 8580 9900 11220 12540 SVC003431 NEEDLE EMG 2200 2860 3300 3740 4180 SVC003432 CEREBRAL THROMBOLYSIS (MORE THAN 1 HOUR) 19800 25740 29700 33660 37620 SVC003433 CEREBRAL THROMBOLYSIS (LESS THAN 1 HOUR) 35750 46480 53630 60780 67930 SVC003434 PERIPHERAL MECHANICAL THROMBOLYSIS 49060 63780 73590 83400 93210 SVC003435 INTRACRANIAL ENDOVASCULAR MECHANICAL THROMBECTOMY 39600 51480 59400 67320 75240 SVC003436 INTRARTERIAL VASODILATATION 15400 20020 23100 26180 29260 SVC003437 BALLOON TEST OCCLUSION-COMPLEX 38500 50050 57750 65450 73150 SVC003439 PERIPHERAL ARTERY EMBOLIZATION 20900 27170 31350 35530 39710 SVC003440 PERIPHERAL ARTERY EMBOLIZATION-COMPLEX 33000 42900 49500 56100 62700 SVC003441 COILING OF INTRACRANIAL ANEURYSM ATTEMPTED 25000 32500 37500 42500 47500 SVC003442 INTRACRANIAL ANGIOPLASTY-COMPLEX 60500 78650 90750 102850 114950 SVC003443 INTRACRANEAL VENOUS THROMBOLYSIS 55000 71500 82500 93500 104500 SVC003444 EXTRA CRANEAL VENOUS THROMBOLYSIS 16500 21450 24750 28050 31350 SVC003446 COILING MINOR 35200 45760 52800 59840 66880 Interventional Radiology PKG003004 VARICOSE VEIN LASER ABLATION (EVLT) (FOR SINGLE LIMB) PKG 27500 35750 41250 46750 52250 PKG003138 CATH DIRECTED VENUS THROMBOLYSIS WITH FILTER PKG 79860 103820 119790 135760 151730 PKG004098 BRONCHIAL ARTERY EMBOLISATION (BAE) (HEMOPTYSIS) WITH GELFOAM PKG 111760 145290 167640 189990 212340 PKG004099 CATHETER DIRECTED PERIPHERAL ARTERIAL THROMBOLYSIS (TWO SESSIONS) PKG 68640 89230 102960 116690 130420 PKG004101 PERCUTANEOUS BILIARY DRAINAGE (PTBD) INTERNAL DRAINAGE + PLASTIC STENTING PKG145200 188760 217800 246840 275880 PKG004102 METALLIC BILIARY STENTING PKG 58080 75500 87120 98740 110350 PKG004104 INTRAVASCULAR FOREIGN BODY RETRIEVAL PKG 34870 45330 52310 59280 66250 PKG004105 TUMOUR ABLATION - SINGLE - A_PKG 101640 132130 152460 172790 193120 PKG004106 DEB TACE_PKG 111760 145290 167640 189990 212340 PKG004107 MODERATE EMBOLISATION_PKG 108680 141280 163020 184760 206490 PKG004108 BILIARY PROCEDURE (B) _PKG 38280 49760 57420 65080 72730 PKG004109 BILIARY CATHETER EXCHANGE_PKG 11220 14590 16830 19070 21320 PKG004110 DRAIN REMOVAL_PKG 6990 9080 10480 11870 13270 PKG004111 VARICOSE VEINS LASER PLUS FOAM 1 LIMB_PKG 137390 178610 206090 233560 261040 PKG004112 FOAM SCLEROTHERAPY_PKG 44770 58200 67160 76110 85060 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite PKG004113 FOAM SCLEROTHERAPY (PER INJECTION)_PKG 11000 14300 16500 18700 20900 PKG004562 KYPHOPLASTY_PKG 101640 132130 152460 172790 193120 PKG004775 NEPHROSTOMY BOTH SIDES_PKG 41580 54050 62370 70690 79000 PKG004948 ANGIOPLASTY COMPLEX_PKG 255530 332190 383300 434400 485510 PKG004949 CAROTID PLASTY_PKG 94380 122690 141570 160450 179320 PKG006094 EXTERNAL BIOPSY_PKG 23210 30170 34820 39460 44100 PKG006202 CAPD CATHETER_PKG 45870 59630 68810 77980 87150 PKG006423 BILIARY BALLOON DILATATION_PKG 55220 71790 82830 93870 104920 PKG006644 UTERINE ARTERY EMBOLISATION (MENORRHAGIA / FIBROID / ADENOMYOSIS) PKG 106810 138850 160220 181580 202940 PKG006645 PROSTATIC ARTERY EMBOLISATION COMPLETE PACKAGE_PKG 190080 247100 285120 323140 361150 PKG006646 OBSTETRIC HEMORRHAGE_PKG 71940 93520 107910 122300 136690 PKG006647 OBSTETRIC HEMORRHAGE OUT_PKG 83050 107970 124580 141190 157800 PKG006649 BILIARY EXTERNAL DRAINAGE_PKG 23540 30600 35310 40020 44730 PKG006650 BILIARY COMBINED PROCEDURE_PKG 19140 24880 28710 32540 36370 PKG006651 BILIARY OTHER PROCEDURE_PKG 17600 22880 26400 29920 33440 PKG006652 BILIARY INTERNAL EXTERNAL DRAIN 2_PKG 57530 74790 86300 97800 109310 PKG006654 TRANSJUGULAR PORTO-SYSTEMIC SHUNT( TIPSS) PKG 326700 424710 490050 555390 620730 PKG006655 TIPSS GRAM_PKG 17380 22590 26070 29550 33020 PKG006658 TRANS-ARTERIAL CHEMO-EMBOLIZATION (TACE) (LIVER TUMORS / METASTASES ) PKG 95810 124550 143720 162880 182040 PKG006661 VARICOSE VEINS COMPLEX PER LIMB_PKG 175670 228370 263510 298640 333770 PKG006665 BELOW KNEE PLASTY (B)_PKG 130680 169880 196020 222160 248290 PKG006666 BILIARY STONE EXTRACTION_PKG 71940 93520 107910 122300 136690 PKG006667 BONE LESION RFA PLUS CEMENTOPLASTY_PKG 127820 166170 191730 217290 242860 PKG006668 COLONIC STENT_PKG 47960 62350 71940 81530 91120 PKG006669 ILIAC OCCLUSION_PKG 103840 134990 155760 176530 197300 PKG006670 MICROWAVE ABLATION_PKG 127820 166170 191730 217290 242860 PKG006671 OESOPHAGEAL STENT_PKG 38280 49760 57420 65080 72730 PKG006672 RENAL PLASTY_PKG 99000 128700 148500 168300 188100 PKG006673 SFA OCCLUSION_PKG 92400 120120 138600 157080 175560 PKG006675 SIMPLE EMBOLISATION_PKG 50380 65490 75570 85650 95720 PKG006676 TUMOUR ABLATION: MULTIPLE (A)_PKG 159720 207640 239580 271520 303470 PKG006677 BILIARY STENT 2 STAGE PROCEDURE_PKG 60720 78940 91080 103220 115370 PKG006678 COMPLEX EMBOLISATION_PKG 140580 182750 210870 238990 267100 PKG006679 FENESTRATED STENT GRAFT_PKG 287540 373800 431310 488820 546330 PKG006680 FISTULA LYSIS PLUS FISTULOPLASTY_PKG 103840 134990 155760 176530 197300 PKG006681 PROSTATIC ARTERY EMBOLISATION_PKG 87890 114260 131840 149410 166990 PKG006682 PROSTATIC ARTERY EMBOLISATION COMPLEX_PKG 151030 196340 226550 256750 286960 PKG006683 RADIOEMBOLISATION_PKG 359480 467320 539220 611120 683010 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite PKG006684 PARTIAL SPLENIC EMBOLISATION_PKG 127820 166170 191730 217290 242860 PKG006685 CT BIOPSY COMPLEX_PKG 22330 29030 33500 37960 42430 PKG006686 PLUGGED RENAL BIOPSY_PKG 14410 18730 21620 24500 27380 PKG006687 TENDON INJECTION_PKG 9630 12510 14440 16360 18290 PKG006688 URETERIC STENT PRIOR NEPHROSTOMY_PKG 28820 37470 43230 48990 54760 PKG006689 FISTULA LYSIS_PKG 40040 52050 60060 68070 76080 PKG006690 FISTULOPLASTY COMPLEX_PKG 109010 141710 163520 185320 207120 PKG006691 GASTRIC STENT_PKG 43560 56630 65340 74050 82760 PKG006906 INTERCOSTAL NEUROLYSIS_PKG 15950 20740 23930 27120 30310 PKG007367 HYDATID CYST_PKG 29040 37750 43560 49370 55180 PKG007448 US BIOPSY_PKG 7260 9440 10890 12340 13790 PKG007451 CT BIOPSY SIMPLE_PKG 12760 16590 19140 21690 24240 PKG007452 BILIARY INTERNAL EXTERNAL DRAIN 1_PKG 31900 41470 47850 54230 60610 PKG007462 CT COMPLEX DRAINAGE_PKG 23980 31170 35970 40770 45560 PKG007463 CT DRAINAGE_PKG 14410 18730 21620 24500 27380 PKG007667 NERVE BLOCK_PKG 12760 16590 19140 21690 24240 PKG007670 VERTEBROPLASTY_PKG 87120 113260 130680 148100 165530 PKG007878 NEPHROSTOMY ONE SIDE_PKG 23210 30170 34820 39460 44100 PKG007930 VARICOSE VEIN LASER GSV 1 LIMB_PKG 83050 107970 124580 141190 157800 PKG007935 IVC FILTER_PKG 43560 56630 65340 74050 82760 PKG007944 PORT INSERTION_PKG 60720 78940 91080 103220 115370 PKG007946 PORT INSERTION COMPLEX_PKG 83050 107970 124580 141190 157800 PKG007963 HICKMAN LINE_PKG 34870 45330 52310 59280 66250 PKG008202 BAND ADJUSTMENT_PKG 19140 24880 28710 32540 36370 PKG008217 BELOW KNEE PLASTY (A)_PKG 103840 134990 155760 176530 197300 PKG008239 BILIARY STENT ONE_PKG 38280 49760 57420 65080 72730 PKG008424 CHECK ANGIO_PKG 10590 13770 15890 18010 20130 PKG008666 VARICOSE VEIN LASER 2 LIMBS_PKG 207680 269980 311520 353060 394590 PKG008754 FIBROID EMBOLISATION PACKAGE 111760 145290 167640 189990 212340 PKG008763 FISTULOPLASTY CUTTING BALLOON_PKG 75460 98100 113190 128280 143370 PKG008904 URETERIC STENT TWO_PKG 63910 83080 95870 108650 121430 PKG008905 URETERIC STENT ONE_PKG 43560 56630 65340 74050 82760 PKG008953 JUVENILE ANGIOFIBROMA_PKG 95810 124550 143720 162880 182040 PKG009385 PELVIC CONGESTION SYNDROME_PKG 102190 132850 153290 173720 194160 PKG009416 PERCUTANEOUS PSEUDOANEURYSM_PKG 14410 18730 21620 24500 27380 PKG010004 TRACHEAL STENT_PKG 37730 49050 56600 64140 71690 PKG010014 TRUS BIOPSY_PKG 15290 19880 22940 25990 29050 PKG010143 VARICOCELE EMBOLISATION BOTH_PKG 134090 174320 201140 227950 254770 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite PKG010144 VARICOCELE EMBOLISATION_PKG 102190 132850 153290 173720 194160 PKG010145 VARICOSE VEINS LASER 2 LIMBS PLUS FOAM_PKG 239580 311450 359370 407290 455200 PKG014894 SVC OCCLUSION, SNARE_PKG 87890 114260 131840 149410 166990 PKG014895 TIPSS ALL INCLUSIVE_PKG 479160 622910 718740 814570 910400 PKG014896 US FNAC_PKG 4400 5720 6600 7480 8360 PKG014897 US DRAINAGE_PKG 7260 9440 10890 12340 13790 PKG014898 PERC CHOLECYSTOSTOMY_PKG 28820 37470 43230 48990 54760 PKG014899 RIG_PKG 60720 78940 91080 103220 115370 PKG014900 FISTULOPLASTY_PKG 55990 72790 83990 95180 106380 PKG014902 CT NERVE ROOT_PKG 12760 16590 19140 21690 24240 PKG014903 CT FNAC_PKG 7700 10010 11550 13090 14630 SVC003306 BRONCHIAL ARTERY EMBOLISATION (BAE) (HEMOPTYSIS) WITH GELFOAM 33000 42900 49500 56100 62700 SVC003309 CATH DIRECTED VENUS THROMBOLYSIS WITH FILTER 33000 42900 49500 56100 62700 SVC003310 UTERINE ARTERY EMBOLISATION (MENORRHAGIA / FIBROID / ADENOMYOSIS) 33000 42900 49500 56100 62700 SVC003312 PERCUTANEOUS BILIARY DRAINAGE (PTBD) EXTERNAL DRAINAGE 13200 17160 19800 22440 25080 SVC003314 METALLIC BILIARY STENTING 16500 21500 24800 28100 31400 SVC003318 PERCUTANEOUS IMAGE GUIDED SCLEROTHERAPY (VENOUS MALFORMATION / HEMANGIOMA)7700 10010 11550 13090 14630 SVC003319 TRANS-ARTERIAL CHEMO-EMBOLIZATION (TACE) (LIVER TUMORS / METASTASES ) 27500 35800 41300 46800 52300 SVC003322 VARICOSE VEIN LASER ABLATION (EVLT) (FOR SINGLE LIMB) 27500 35800 41300 46800 52300 SVC003323 PERCUTANEOUS NEPHROSTOMY (PCN) (OBSTRUCTIVE UROPATHY) 12320 16020 18480 20940 23410 SVC003324 INTRAVASCULAR FOREIGN BODY RETRIEVAL 22000 28600 33000 37400 41800 SVC003325 TUMOUR ABLATION - SINGLE - A 27500 35800 41300 46800 52300 SVC003328 BONE LESION RFA + CEMENTOPLASTY 33000 42900 49500 56100 62700 SVC003330 ILIAC OCCLUSION 33000 42900 49500 56100 62700 SVC003331 MICROWAVE ABLATION (MWA) 27500 35800 41300 46800 52300 SVC003338 EMBOLIZATION - SIMPLE 26880 34940 40320 45700 51070 SVC003339 SVC OCCLUSION - SNARE 25000 32500 48700 42500 47500 SVC003342 EMBOLIZATION - COMPLEX 38500 50050 57750 65450 73150 SVC003343 DEB TACE 27500 35800 41300 46800 52300 SVC003344 ENDOVASCULAR ANEURYSM REPAIR WITH FENESTRATED STENT GRAFT 88000 114400 132000 149600 167200 SVC003346 EMBOLIZATION - MODERATE 30800 40040 46200 52360 58520 SVC003347 PROSTATIC ARTERY EMBOLISATION 33000 42900 49500 56100 62700 SVC003353 RENAL BIOPSY - PLUGGED 6600 8600 9900 11300 12600 SVC003355 VARICOCELE EMBOLISATION 22000 28600 33000 37400 41800 SVC003356 URETERIC STENT PRIOR NEPHROSTOMY 11000 14300 16500 18700 20900 SVC003358 FISTULOLYSIS 18480 24020 27720 31420 35110 SVC003359 FISTULOPLASTY - COMPLEX 27500 35800 41300 46800 52300 SVC003361 DRAIN REMOVAL 1100 1500 1700 1900 2100 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003362 VARICOSE VEINS - LASER - MULTIPLE VEINS - UNILATERAL 110440 143570 165660 187750 209840 SVC003372 IMAGE GUIDED TUNELLED CATHETER / CHEMOPORT INSERTION 13200 17160 19800 22440 25080 SVC003374 IMAGE GUIDED JOINT / TENDON SHEATH INJECTION 3300 4300 5000 5700 6300 SVC003375 IMAGE GUIDED CELIAC/SPLANCHNIC/SUPERIOR HYPOGASTRIC PLEXUS BLOCK / NEUROLYSIS8800 11500 13200 15000 16800 SVC003377 INTERNALISATION OF EXTERNAL PTBD 11000 14300 16500 18700 20900 SVC003379 PERCUTANEOUS ASPIRATION AND REINSTILLATION (PAIR) FOR HYDATID CYST 10000 10000 13000 19500 17000 19000 SVC003382 USG GUIDED COMPRESSION THROMBOSIS OF PSEUDOANEURYSM OR THROMBIN11000 INJECTION11000 14300 16500 18700 20900 SVC003383 BRONCHIAL ARTERY EMBOLISATION (BAE) 16500 21500 24800 28100 31400 SVC003389 REMOVAL OF IVC FILTER 22000 22000 28600 33000 37400 41800 SVC003390 TRUS GUIDED PROSTATE BIOPSY 8800 8800 11500 13200 15000 16800 SVC003392 USG GUIDED PER CUTANEOUS COLLECTION OF DRAINAGE 5500 6000 6000 6000 6000 6000 SVC003394 USG GUIDED FLUID TAPPING ASCITIC DIAGNOSTIC 3600 3600 3600 3600 3600 3600 SVC003395 USG GUIDED FLUID TAPPING ASCITIC THERAPEUTIC 6620 6620 6620 6620 6620 6620 SVC003396 USG GUIDED FLUID TAPPING PLEURAL DIAGNOSTIC 3300 3300 3300 3300 3300 3300 SVC003397 USG GUIDED FLUID TAPPING PLEURAL THERAPEUTIC 5500 6000 6000 6000 6000 6000 SVC003401 IR REVIEW 800 1200 1200 1200 1200 1200 SVC003403 VERTEBROPLASTY(INR) 22000 28600 33000 37400 41800 SVC003404 BILIARY BALLOON DILATATION 15000 19500 22500 25500 28500 SVC003405 BILIARY PROCEDURE 8400 10920 12600 14280 15960 SVC003406 IMAGE GUIDED NERVE BLOCK-ONE SITE 3000 3900 4500 5100 5700 SVC003407 PERCUTANEOUS TRANS HEPATIC BILIARY DRAINGE (PTBD)-EXTERNAL+INTERNAL 15000 19500 22500 25500 28500 SVC003408 USG GUIDED FNAC (SUPERFICIAL) 4120 5360 6180 7000 7830 SVC003409 CHECK ANGIOGRAM / VENOGRAM 5500 7150 8250 9350 10450 SVC003410 CORROBORATIVE CT LIMITED POST-PROCEDURE WITHOUT FILMS 1980 2570 2970 3370 3760 SVC003411 PERIPHERAL THROMBOLYSIS 22000 28600 33000 37400 41800 SVC003412 USG GUIDED BIOPSY-SUPERFICIAL 6470 8410 9710 11000 12290 SVC003413 IMAGE GUIDANCE IN OT(SHORT) 3300 4300 5000 5700 6300 SVC003414 IMAGE GUIDANCE IN OT 9240 9240 9240 9240 9240 SVC010630 NUCLEOPLASTY 29330 38120 43990 49850 55720 Laboratory PKG013712 ARTHRITIS PACKAGE 1(RHEUMATOID ARTHRITIS) PKG 4400 4400 5720 6600 7480 8360 PKG021207 KIDNEY & PROSTATE CLINICÂ 330 330 430 500 560 630 SVC003447 MUSCLE BIOPSY(HISTOPATHOLOGY) 2100 3150 3150 3150 3150 3150 SVC003449 GLUCOSE TOLERANCE TEST(GESTATIONAL) 280 430 430 430 430 430 SVC003451 24 HOURS URINE FOR CATECHOLAMINES 4730 7090 7090 7090 7090 7090 SVC003452 24 HOURS URINE FOR COPPER 1850 2780 2780 2780 2780 2780 SVC003455 24 HOURS URINE FOR ELECTROLYTES 470 710 710 710 710 710 SVC003457 24 HOURS URINE FOR MICROALBUMIN 580 870 870 870 870 870 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003458 24 HOURS URINE FOR POTASSIUM 250 380 380 380 380 380 SVC003459 24 HOURS URINE FOR PROTEIN 310 470 470 470 470 470 SVC003460 24 HOURS URINE CREATININE CLEARANCE TEST 590 890 890 890 890 890 SVC003461 24 HOURS URINE FOR CALCIUM 280 420 420 420 420 420 SVC003462 24 HOURS URINE FOR PHOSPHORUS 310 470 470 470 470 470 SVC003463 24 HOURS URINE FOR URIC ACID 310 470 470 470 470 470 SVC003465 ACE (ANGIOTENSIN CONVERTING ENZYME) 1160 1740 1740 1740 1740 1740 SVC003466 ADRENOCORTICOTROPIC HORMONE (ACTH) 1550 2330 2330 2330 2330 2330 SVC003467 ADENOSINE DEAMINASE 690 1040 1040 1040 1040 1040 SVC003468 AEC (ABSOLUTE ESONIPHIL COUNT) 190 290 290 290 290 290 SVC003469 AFB CULTURE & RADIOMETRIC SUSEPTIBILITY - 5 DRUG PANEL 6350 9530 9530 9530 9530 9530 SVC003470 AFB CULTURE/MYCOBACTERIAL CULTURE (BACTEC METHOD) 1850 2780 2780 2780 2780 2780 SVC003471 AFB CULTURE/MYCOBACTERIAL CULTURE (LJ METHOD) 1210 1810 1810 1810 1810 1810 SVC003472 AFB SMEAR 210 320 320 320 320 320 SVC003473 ALPHA FETO PROTEIN (AFP) 920 1380 1380 1380 1380 1380 SVC003474 ALKALINE PHOSPHATASE (ALP) 200 300 300 300 300 300 SVC003476 ANCA (P/C) 1870 2810 2810 2810 2810 2810 SVC003477 ANTI -CARDIOLIPIN ANTIBODY (ANTI-PHOSPHOLIPID) IGG 820 1230 1230 1230 1230 1230 SVC003478 ANTI -CARDIOLIPIN ANTIBODY (ANTI-PHOSPHOLIPID) IGM 840 1260 1260 1260 1260 1260 SVC003479 ANTI CYCLIC CITRULLINATED PEPTIDE;ANTI CCP 2030 3050 3050 3050 3050 3050 SVC003480 ANTI DNASE B, SERUM; ANTIDEOXYRIBONUCLEASE B 1260 1890 1890 1890 1890 1890 SVC003481 ANTI DS DNA 1320 1980 1980 1980 1980 1980 SVC003482 ANTI HAV-TOTAL 1630 2440 2440 2440 2440 2440 SVC003483 ANTI -HBC IGM ANTIBODY 1100 1650 1650 1650 1650 1650 SVC003484 ANTI HBC TOTAL 1270 1910 1910 1910 1910 1910 SVC003485 ANTI HCV IGG 2210 3320 3320 3320 3320 3320 SVC003486 ANTI HCV IGM 2420 3630 3630 3630 3630 3630 SVC003487 AUTOIMMUNE HEPATITIS PANEL (AMA, ANTI LKM, ANTI L/P) 7040 10550 10550 10550 10550 10550 SVC003488 ANTI -LKM-1(LIVER KIDNEY MICROSOMAL ANTIBODIES ) 3100 4650 4650 4650 4650 4650 SVC003489 ANTI MITOCHONDRIAL ANTIBODY 1960 2940 2940 2940 2940 2940 SVC003490 ANTI MULLERIAN HORMONE 2140 3210 3210 3210 3210 3210 SVC003491 ANTI NUCLEAR ANTIBODY / FACTOR (ANA / ANF), IFA (HEP-2) IN DILUTIONS 2310 3470 3470 3470 3470 3470 SVC003492 ANTI NUCLEAR ANTIBODY / FACTOR (ANA/ANF), EIA 740 1110 1110 1110 1110 1110 SVC003493 ANTI NUCLEAR ANTIBODY / FACTOR (ANA/ANF), IFA (HEP-2) 2310 3470 3470 3470 3470 3470 SVC003494 ANTI-HAV IGM 1380 2070 2070 2070 2070 2070 SVC003496 APOLIPOPROTIENS 1020 1530 1530 1530 1530 1530 SVC003497 APOLIPOPROTEIN B 710 1070 1070 1070 1070 1070 SVC003498 ARTERIAL LINE TIP FOR CULTURE & SENSITIVITY 790 1180 1180 1180 1180 1180 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003499 ASCITIC FLUID FOR CYTOLOGY/MALIGNANT CELLS 480 720 720 720 720 720 SVC003500 ASLO QUALITATIVE 340 500 500 500 500 500 SVC003501 ASMA (ANTI-SMOOTH MUSCLE ANTIBODIES) 1960 2940 2940 2940 2940 2940 SVC003502 ASO (ANTISTREPTOLYSIN "O") 680 1020 1020 1020 1020 1020 SVC003503 ASPIRATED FLUID ANALYSIS 910 1370 1370 1370 1370 1370 SVC003504 ASPIRATED FLUID ANALYSIS (BIOCHEMISTRY) 480 720 720 720 720 720 SVC003505 ASPIRATED FLUID FOR C/S 790 1180 1180 1180 1180 1180 SVC003506 BAL FLUID (BRONCHO ALVEOLAR LAVAGE) FOR AFB C/S 1800 2700 2700 2700 2700 2700 SVC003507 BAL FLUID (BRONCHO ALVEOLAR LAVAGE) FOR AFB STAIN 210 320 320 320 320 320 SVC003508 BAL FLUID (BRONCHO ALVEOLAR LAVAGE) FOR C/S 910 1370 1370 1370 1370 1370 SVC003509 BAL FLUID (BRONCHO ALVEOLAR LAVAGE) FOR FUNGAL C/S 1170 1750 1750 1750 1750 1750 SVC003510 BAL FLUID (BRONCHO ALVEOLAR LAVAGE) FOR GRAMS STAIN 200 300 300 300 300 300 SVC003511 BAL FLUID FOR CYTOLOGY (BRONCHIAL WASH/ALVEOLAR LAVAGE) 590 880 880 880 880 880 SVC003512 BAL FLUID FOR FUNGAL STAIN 200 300 300 300 300 300 SVC003515 BETA HUMAN CHORIONIC GONADOTROPIN (BETA HCG) 760 1140 1140 1140 1140 1140 SVC003516 BILE FOR CULTURE & SENSITIVITY 830 1240 1240 1240 1240 1240 SVC003517 BILIRUBIN DIRECT 150 230 230 230 230 230 SVC003518 BILIRUBIN INDIRECT 130 200 200 200 200 200 SVC003519 BILIRUBIN TOTAL 150 230 230 230 230 230 SVC003521 BLOOD CLOT FOR C/S 560 830 830 830 830 830 SVC003522 BLOOD CULTURE FOR FUNGUS 1160 1730 1730 1730 1730 1730 SVC003523 BLOOD FOR ANAEROBIC CULTURE/SENSITIVITY 1320 1980 1980 1980 1980 1980 SVC003524 BLOOD FOR C/S 1330 2000 2000 2000 2000 2000 SVC003525 BLOOD FOR CULTURE & SENSITIVITY AEROBIC 1300 1950 1950 1950 1950 1950 SVC003526 BONE MARROW BIOPSY REPORTING 880 1320 1320 1320 1320 1320 SVC003527 BRONCHIAL ASPIRATION FOR CULTURE & SENSITIVITY 790 1180 1180 1180 1180 1180 SVC003528 BT/CT BLEEDING TIME & CLOTTING TIME 210 320 320 320 320 320 SVC003529 BLOOD UREA NITROGEN (BUN) 170 260 260 260 260 260 SVC003530 CA - 125 1390 2090 2090 2090 2090 2090 SVC003531 CA - 15 - 3 1350 2030 2030 2030 2030 2030 SVC003532 CA - 19 - 9 1560 2340 2340 2340 2340 2340 SVC003533 CALCIUM 250 380 380 380 380 380 SVC003534 CANCA 1800 2700 2700 2700 2700 2700 SVC003535 CAPD FLUID FOR CULTURE & SENSITIVITY 790 1180 1180 1180 1180 1180 SVC003536 CAPD FLUID FOR FUNGAL CULTURE 1100 1650 1650 1650 1650 1650 SVC003537 CARBAMAZEPINE 800 1200 1200 1200 1200 1200 SVC003539 CAVAFIX TIP FOR C/S 460 690 690 690 690 690 SVC003540 CARCINO EMBRYONIC ANTIGEN (CEA) 780 1170 1170 1170 1170 1170 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003541 CENTRAL LINE TIP FOR C/S 790 1180 1180 1180 1180 1180 SVC003542 CERULOPLASMIN 1270 1910 1910 1910 1910 1910 SVC003543 CERVICAL SWAB FOR C/S 790 1180 1180 1180 1180 1180 SVC003545 CHLORIDE 160 240 240 240 240 240 SVC003546 CHOLESTEROL TOTAL 160 240 240 240 240 240 SVC003547 CHROMOSOME (KARYOTYPE) ANALYSIS, BLOOD 2990 4490 4490 4490 4490 4490 SVC003548 CREATINE KINASE- MB (CK-MB) 670 1010 1010 1010 1010 1010 SVC003549 CMV IGG ANTIBODY (CYTOMEGALOVIRUS) 1000 1500 1500 1500 1500 1500 SVC003550 COMPLEMENT C3 760 1140 1140 1140 1140 1140 SVC003551 COMPLEMENT C4 760 1140 1140 1140 1140 1140 SVC003552 CONJUNCTIVAL SWAB FOR C/S 790 1180 1180 1180 1180 1180 SVC003553 CONJUNCTIVAL SWAB FOR FUNGAL CULTURE 1100 1650 1650 1650 1650 1650 SVC003556 SERUM CORTISOL (4PM) 580 870 870 870 870 870 SVC003557 SERUM CORTISOL (8 AM) 640 960 960 960 960 960 SVC003558 CREATINE KINASE (CK/CPK) 550 830 830 830 830 830 SVC003559 CRP (C -REACTIVE PROTEIN) 500 750 750 750 750 750 SVC003560 CSF AFB STAIN 180 270 270 270 270 270 SVC003561 CSF ANALYSIS (BIOCHEMISTRY) 490 740 740 740 740 740 SVC003562 CSF CELL COUNT 400 600 600 600 600 600 SVC003563 CSF FOR C/S 830 1240 1240 1240 1240 1240 SVC003564 CSF FOR CYTOLOGY/MALIGNANT CELLS 580 870 870 870 870 870 SVC003565 CSF FOR FUNGAL CULTURE 1160 1730 1730 1730 1730 1730 SVC003566 CSF FOR GRAM STAIN 160 240 240 240 240 240 SVC003567 CSF FOR INDIA INK 320 480 480 480 480 480 SVC003568 CSF FOR Z-N STAIN (AFB STAIN) 170 260 260 260 260 260 SVC003569 CSF PROTEIN ELECTROPHORESIS 5250 7880 7880 7880 7880 7880 SVC003571 CVP TIP FOR CULTURE & SENSITIVITY 790 1190 1190 1190 1190 1190 SVC003572 CYCLOSPORINE LEVEL 2640 3960 3960 3960 3960 3960 SVC003573 CYSTIC FLUID (BIOCHEMISTRY) 440 660 660 660 660 660 SVC003574 CYSTIC FLUID FOR CYTOLOGY 460 690 690 690 690 690 SVC003575 CYTOLOGY 510 770 770 770 770 770 SVC003576 DIFFERENTIAL COUNT (DC) 170 260 260 260 260 260 SVC003577 D-DIMER 1200 1800 1800 1800 1800 1800 SVC003581 DHEA SULPHATE (DHEAS) 1160 1740 1740 1740 1740 1740 SVC003582 DIALYSIS CATHETER TIP FOR C/S 790 1180 1180 1180 1180 1180 SVC003585 DIALYSIS WATER FOR C/S 510 770 770 770 770 770 SVC003586 DIGOXIN 900 1350 1350 1350 1350 1350 SVC003587 DRAIN FLUID FOR C/S 530 800 800 800 800 800 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003588 EAR SWAB FOR CULTURE & SENSITIVITY 750 1130 1130 1130 1130 1130 SVC003590 ECHINOCOCCUS (HYDATID SEROLOGY)IGG, SERUM 1260 1890 1890 1890 1890 1890 SVC003591 ELECTROLYTES (NA+,K+,CL+, HCO3-) 450 680 680 680 680 680 SVC003595 ERYTHROCYTE SEDIMENTATION RATE (ESR) 160 240 240 240 240 240 SVC003596 ESTRADIOL II (E2) 680 1020 1020 1020 1020 1020 SVC003597 ET SECRETION FOR C/S 790 1190 1190 1190 1190 1190 SVC003598 ET SECRETION FOR GRAMS STAIN 140 210 210 210 210 210 SVC003599 ET SECRETIONS FUNGAL STAIN 180 270 270 270 270 270 SVC003600 ET SECRETIONS Z-N STAIN (AFB STAIN) 180 270 270 270 270 270 SVC003601 EVD TIP FOR C/S 440 660 660 660 660 660 SVC003603 EYE SWAB FOR CULTURE & SENSITIVITY 750 1130 1130 1130 1130 1130 SVC003604 FACTOR IX ASSAY 1750 2630 2630 2630 2630 2630 SVC003605 FACTOR V ASSAY 3360 5040 5040 5040 5040 5040 SVC003606 FACTOR VII ASSAY 3940 5910 5910 5910 5910 5910 SVC003607 FACTOR VIII ASSAY 1980 2970 2970 2970 2970 2970 SVC003609 FACTOR XIII 480 720 720 720 720 720 SVC003610 FDP (FIBRINOGEN DEGRADATION PRODUCTS) 1190 1790 1790 1790 1790 1790 SVC003611 FIBRINOGEN ASSAY 1100 1650 1650 1650 1650 1650 SVC003612 FLUID FOR CULTURE & SENSITIVITY 830 1250 1250 1250 1250 1250 SVC003613 FLUID FOR CYTOLOGY 500 760 760 760 760 760 SVC003614 FLUID FOR GRAM STAIN 350 530 530 530 530 530 SVC003615 FNAC 920 1380 1380 1380 1380 1380 SVC003616 FOLIC ACID LEVEL 2430 3650 3650 3650 3650 3650 SVC003617 FREE TESTOSTERONE 2140 3210 3210 3210 3210 3210 SVC003618 FSH (FOLLICLE STIMULATING HORMONE) 620 930 930 930 930 930 SVC003619 FREE TRIIODOTHYRONINE (FT3) 420 630 630 630 630 630 SVC003620 FREE THYROXINE (FT4) 660 660 660 660 660 660 SVC003621 FUNGAL CULTURE 1330 2000 2000 2000 2000 2000 SVC003622 G6 PD 920 1380 1380 1380 1380 1380 SVC003624 GASTRIC ASPIRATE FOR C/S 460 690 690 690 690 690 SVC003625 GASTRIC SECRETION FOR AFB SMEAR 180 270 270 270 270 270 SVC003626 GAMMA GLUTAMYL TRANSFERASE (GGT) 270 420 420 420 420 420 SVC003627 GLOMERULAR BASEMENT MEMBRANE (GBM) ANTIBODY, IFA 1520 2280 2280 2280 2280 2280 SVC003628 FASTING BLOOD SUGAR (FBS) 110 170 170 170 170 170 SVC003629 POST PRANDIAL BLOOD SUGAR (PPBS) 110 170 170 170 170 170 SVC003630 RANDOM BLOOD SUGAR (RBS) 100 150 150 150 150 150 SVC003631 GLUCOSE TOLERANCE TEST (GTT) 160 240 240 240 240 240 SVC003632 HBA1C 550 830 830 830 830 830 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003633 GRAMS STAIN SMEAR 390 590 590 590 590 590 SVC003634 GROIN SWAB FOR C/S 560 830 830 830 830 830 SVC003635 HANGING DROP PREPARATION 140 200 200 200 200 200 SVC003636 HAPTOGLOBLIN 2000 2990 2990 2990 2990 2990 SVC003637 HB ELECTROPHORESIS 1100 1650 1650 1650 1650 1650 SVC003638 HAEMOGLOBIN (HB%) 150 230 230 230 230 230 SVC003639 HBE AG 900 1350 1350 1350 1350 1350 SVC003640 HBSAG (HEPATITS B SURFACE ANTIGEN) - CHEMILUMINESCENCE 610 920 920 920 920 920 SVC003641 HCV (ANTI HCV ANTIBODY) - CHEMILUMINESCENCE 1770 2660 2660 2660 2660 2660 SVC003642 HDL CHOLESTROL (HDLC) 270 410 410 410 410 410 SVC003643 HEPATITIS B E ANTIBODY (ANTI HBE) 800 1200 1200 1200 1200 1200 SVC003644 HEPATITIS C VIRUS RNA (HCV RNA) QUANTITATIVE, REAL TIME PCR 5200 7800 7800 7800 7800 7800 SVC003645 HEPATITIS C VIRUS RNA (HCV RNA) QUALITATIVE, REAL TIME PCR 5940 8910 8910 8910 8910 8910 SVC003646 HEPATITIS E (HEV), IGM 1850 2780 2780 2780 2780 2780 SVC003647 HISTOPATHOLOGY, KIDNEY BIOPSY PANEL 1 (HISTOPATHOLOGY ,SPECIAL STAINS3600 ,DIF FOR5400 IGG,IGA, IGM,5400 C3 & C1Q5400 ,MICROPHOTOGRAPHY)5400 5400 SVC003648 HIV - CHEMILUMINESCENCE 590 890 890 890 890 890 SVC003649 HLA B27 2590 3890 3890 3890 3890 3890 SVC003650 HOMOCYSTEINE 1040 1560 1560 1560 1560 1560 SVC003652 IMD PANEL, QUANTITATIVE, BLOOD (AMINO ACIDS, ORGANIC ACIDS, FATTY ACIDS)4200 6300 6300 6300 6300 6300 SVC003653 INDIA INK CRYPTOCOCCUS 190 280 280 280 280 280 SVC003655 INTERLEUKIN-6(IL-6) 3150 3300 3300 3300 3300 3300 SVC003656 IONISED CALCIUM 670 1010 1010 1010 1010 1010 SVC003657 TOTAL IRON 530 800 800 800 800 800 SVC003659 IV CANNULA TIP FOR C/S 460 690 690 690 690 690 SVC003661 KIDNEY BIOPSY - HISTOPATHOLOGY 2100 3150 3150 3150 3150 3150 SVC003662 KOH PREPARATION FUNGUS 350 530 530 530 530 530 SVC003663 LACTATE (LACTIC ACID) 970 1460 1460 1460 1460 1460 SVC003665 LDH TOTAL 410 620 620 620 620 620 SVC003666 LDL CHOLESTEROL 320 480 480 480 480 480 SVC003667 LUTEINIZING HORMONE (LH) 660 990 990 990 990 1020 SVC003668 LIPASE 740 1110 1110 1110 1110 1110 SVC003669 LIVER ABSCESS ASPIRATE FOR C/S 790 1180 1180 1180 1180 1180 SVC003670 LIVER KIDNEY MICROSOMES LKM -1 1850 2780 2780 2780 2780 2780 SVC003673 MAGNESIUM 600 900 900 900 900 900 SVC003674 MALARIAL PARASITE ( MP ) - BY CARD METHOD 180 270 270 270 270 270 SVC003675 MANTOUX SKIN TEST (PPD) 250 380 380 380 380 380 SVC003676 MATERNAL SERUM SCREEN 3 - TRIPLE TEST (AFP ,BETA HCG ,FREE ESTRIAL ,RISK2700 EVALUATION)4050 4050 4050 4050 4050 SVC003677 MCH (MEAN CORPUSCULAR HAEMOGLOBIN) 130 190 190 190 190 190 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003678 MCHC (MEAN CORPUSCULAR HAEMOGLOBIN CONCENTRATION) 130 190 190 190 190 190 SVC003679 MCV (MEAN CORPUSCULAR VOLUME) 140 200 200 200 200 200 SVC003680 MEASLES IGM ANTIBODIES 1680 2520 2520 2520 2520 2520 SVC003682 MEDIASTINAL FLUID FOR CULTURE & SENSITIVITY (C/S) 790 1180 1180 1180 1180 1180 SVC003684 MYCOBACTERIUM TUBERCULOSIS ANTIBODY IGM 1370 2050 2050 2050 2050 2050 SVC003685 NAIL CLIPPING FUNGAL CULTURE 1220 1830 1830 1830 1830 1830 SVC003686 NAIL CLIPPING KOH PREPARATION 200 300 300 300 300 300 SVC003687 NASAL SWAB FOR C/S 920 1380 1380 1380 1380 1380 SVC003690 ORAL ULCER SWAB FOR C/S 460 690 690 690 690 690 SVC003691 PANCA 1800 2700 2700 2700 2700 2700 SVC003692 PAP SMEAR 680 1020 1020 1020 1020 1020 SVC003693 PCOD PANEL 3260 4880 4880 4880 4880 4880 SVC003694 PCR FOR HBV DNA -QUALITATIVE 5080 7620 7620 7620 7620 7620 SVC003695 PCR FOR HBV DNA -QUANTIFICATION 8660 12990 12990 12990 12990 12990 SVC003696 PCV (PACKED CELL VOLUME) / HEMATOCRIT 170 260 260 260 260 260 SVC003697 PERICARDIAL FLUID - CLINICAL PATHOLOGY, CELL COUNT & CELL TYPE 420 630 630 630 630 630 SVC003698 PERICARDIAL FLUID FOR AFB STAIN 180 270 270 270 270 270 SVC003699 PERICARDIAL FLUID FOR ANALYSIS (BIOCHEMISTRY) 460 690 690 690 690 690 SVC003700 PERICARDIAL FLUID FOR CULTURE AND SENSITIVITY 1160 1730 1730 1730 1730 1730 SVC003701 PERICARDIAL FLUID FOR CYTOLOGY/MALIGNANT CELLS 500 760 760 760 760 760 SVC003702 PERICARDIAL FLUID FOR GRAMS STAIN 140 200 200 200 200 200 SVC003705 PERIPHERAL SMEAR EXAMINATION 180 270 270 270 270 270 SVC003706 PERIPHERAL SMEAR FOR MP & MF 160 240 240 240 240 240 SVC003707 PERITONEAL FLUID AFB STAIN/ ZN STAIN 190 290 290 290 290 290 SVC003708 PERITONEAL/ ASCITIC FLUID FOR CYTOLOGY 960 960 960 960 960 960 SVC003709 PERITONEAL FLUID FOR FUNGAL CULTURE 1110 1670 1670 1670 1670 1670 SVC003710 PERITONEAL FLUID FOR FUNGAL STAIN 180 270 270 270 270 270 SVC003711 PERITONEAL FLUID FOR GRAM STAIN 170 260 260 260 260 260 SVC003712 PERITONEAL FLUID/ ASCITIC FLUID FOR C/ S 790 1190 1190 1190 1190 1190 SVC003713 PERITONEAL / ASCITIC FLUID- BIOCHEMISTRY 490 740 740 740 740 740 SVC003714 PHENOBARBITONE 920 1380 1380 1380 1380 1380 SVC003715 PHENYTOIN 1020 1530 1530 1530 1530 1530 SVC003716 PHOSPHORUS 190 290 290 290 290 290 SVC003717 PLATELET COUNT 60 90 90 90 90 90 SVC003719 PLEURAL FLUID ANALYSIS (CLINICAL PATHOLOGY) 950 1430 1430 1430 1430 1430 SVC003720 PLEURAL FLUID FOR CULTURE & SENSITIVITY 920 1380 1380 1380 1380 1380 SVC003721 PLEURAL FLUID FOR CYTOLOGY 680 1020 1020 1020 1020 1020 SVC003722 PLEURAL FLUID FOR FUNGAL CULTURE 1160 1730 1730 1730 1730 1730 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003723 PLEURAL FLUID FOR FUNGAL STAIN 190 280 280 280 280 280 SVC003724 PLEURAL FLUID FOR GRAM STAIN 200 300 300 300 300 300 SVC003725 PLEURAL FLUID FOR Z-N STAIN ( AFB STAIN) 330 500 500 500 500 500 SVC003728 POTASSIUM, SERUM 200 300 300 300 300 300 SVC003730 PROGESTERONE 640 960 960 960 960 960 SVC003731 PROLACTIN 610 920 920 920 920 920 SVC003732 PROTEIN ELECTROPHORESIS, SERUM INCLUDES TOTAL PROTEIN, ELECT 4410 6620 6620 6620 6620 6620 SVC003733 PROSTATE SPECIFIC ANTIGEN (PSA) 920 1380 1380 1380 1380 1380 SVC003734 PT - INR (PROTHROMBIN TIME) 450 680 680 680 680 680 SVC003735 PARATHYROID HORMONE (PTH) 1850 2780 2780 2780 2780 2780 SVC003736 PTT (ACTIVATED THROMBOPLASTIN TIME) 600 900 900 900 900 900 SVC003737 PUS FOR ANAEROBIC C/S 1470 2210 2210 2210 2210 2210 SVC003738 PUS FOR CULTURE & SENSITIVITY 870 1310 1310 1310 1310 1310 SVC003739 PUS FOR FUNGAL CULTURE 1160 1730 1730 1730 1730 1730 SVC003740 PUS FOR FUNGAL STAIN 210 320 320 320 320 320 SVC003741 PUS FOR GRAM STAIN 200 300 300 300 300 300 SVC003742 PUS FOR Z-N STAIN (AFB STAIN) 210 320 320 320 320 320 SVC003744 PUS FROM LUNG ABSCESS FOR C/S 460 690 690 690 690 690 SVC003745 QUANTIFERON TB GOLD 2680 4020 4020 4020 4020 4020 SVC003746 RANDOM URINE CALCIUM 260 390 390 390 390 390 SVC003747 RANDOM URINE CHLORIDE 270 410 410 410 410 410 SVC003748 RANDOM URINE CREATININE 270 410 410 410 410 410 SVC003749 RANDOM URINE PHOSPHOROUS 260 390 390 390 390 390 SVC003750 RANDOM URINE URIC ACID 260 390 390 390 390 390 SVC003752 RED BLOOD CELL COUNT 130 200 200 200 200 200 SVC003753 REGULAR HP LARGE SPECIMEN 2630 3950 3950 3950 3950 3950 SVC003754 REGULAR HP SMALL SPECIMEN 870 1310 1310 1310 1310 1310 SVC003755 RETICULOCYTE COUNT 440 660 660 660 660 660 SVC003756 RHEUMATOID FACTOR -SERUM 520 780 780 780 780 780 SVC003757 RHEUMATOID FACTOR- SYNOVIAL FLUID 470 710 710 710 710 710 SVC003758 RUBELLA IGG ANTIBODY 660 990 990 990 990 990 SVC003759 SERUM CREATININE 180 270 270 270 270 270 SVC003761 SEMEN ANALYSIS 560 840 840 840 840 840 SVC003762 SEMEN FOR C/S 830 1250 1250 1250 1250 1250 SVC003763 SERUM ALBUMIN 160 240 240 240 240 240 SVC003764 SERUM AMYLASE 490 740 740 740 740 740 SVC003765 SERUM CHOLINESTERASE 510 770 770 770 770 770 SVC003767 SERUM CORTISOL RANDOM 610 920 920 920 920 920 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003768 SERUM FERRITIN 900 1350 1350 1350 1350 1350 SVC003769 SERUM GLOBULIN 200 300 300 300 300 300 SVC003770 SERUM IGA 370 560 560 560 560 560 SVC003771 SERUM IGE 1020 1530 1530 1530 1530 1530 SVC003772 SERUM IGG 410 620 620 620 620 620 SVC003773 SERUM IGM 590 890 890 890 890 890 SVC003774 SERUM IMMUNOGLOBULIN (IGA IGM IGG ) 1040 1560 1560 1560 1560 1560 SVC003775 SERUM LITHIUM 340 510 510 510 510 510 SVC003776 SERUM OSMOLALITY (CALCULATED) 840 1260 1260 1260 1260 1260 SVC003777 SERUM TIBC 560 840 840 840 840 840 SVC003778 SGOT (AST) 200 300 300 300 300 300 SVC003779 SGPT (ALT) 200 300 300 300 300 300 SVC003780 SICKLING TEST 170 250 250 250 250 250 SVC003782 SKIN SCRAPING FOR FUNGAL CULTURE 1100 1650 1650 1650 1650 1650 SVC003784 SODIUM, SERUM 200 300 300 300 300 300 SVC003785 SPUTUM FOR AFB (ZN STAIN) 350 530 530 530 530 530 SVC003786 SPUTUM FOR CULTURE AND SENSITIVITY 870 1310 1310 1310 1310 1310 SVC003787 SPUTUM FOR FUNGAL CULTURE 1270 1910 1910 1910 1910 1910 SVC003788 SPUTUM FOR MALIGNANT CELLS 480 720 720 720 720 720 SVC003789 SPUTUM FUNGAL STAIN 210 320 320 320 320 320 SVC003790 SPUTUM GRAM STAIN 410 610 610 610 610 610 SVC003792 STERNAL SWAB FOR C/S 460 690 690 690 690 690 SVC003794 STOOL (OCCULT BLOOD) 180 270 270 270 270 270 SVC003795 STOOL CULTURE & SENSITIVITY 810 1220 1220 1220 1220 1220 SVC003796 STOOL REDUCING SUBSTANCES 160 240 240 240 240 240 SVC003797 STOOL ROUTINE EXAMINATION 150 230 230 230 230 230 SVC003800 SUCTION TIP FOR C/S 590 880 880 880 880 880 SVC003801 SWAB FOR CULTURE 920 1380 1380 1380 1380 1380 SVC003802 SWINE FLU H1N1 TEST 4500 4500 4500 4500 4500 4500 SVC003803 SYNOVIAL FLUID FOR ANALYSIS (BIO) 1010 1510 1510 1510 1510 1510 SVC003804 SYNOVIAL FLUID FOR CULTURE & SENSITIVITY 620 930 930 930 930 930 SVC003805 SYNOVIAL FLUID FOR CYTOLOGY 1000 1500 1500 1500 1500 1500 SVC003807 SYNOVIAL FLUID FOR GRAM STAIN 190 290 290 290 290 290 SVC003808 SYNOVIAL FLUID FOR ZN STAIN (AFB) 200 300 300 300 300 300 SVC003809 THYROID PROFILE (T3, T4, TSH) 650 980 980 980 980 980 SVC003810 TC & DC 180 270 270 270 270 270 SVC003811 TOTAL COUNT (TC) 150 230 230 230 230 230 SVC003812 TESTOSTERONE 690 1040 1040 1040 1040 1040 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003813 THROAT SWAB FOR ALBERTS STAIN 260 390 390 390 390 390 SVC003814 THROAT SWAB FOR CULTURE & SENSITIVITY 920 1380 1380 1380 1380 1380 SVC003815 THROMBIN TIME 740 1100 1100 1100 1100 1100 SVC003816 TISSUE FOR C/S 920 1380 1380 1380 1380 1380 SVC003817 TONGUE SWAB FOR CULTURE & SENSITIVITY 460 690 690 690 690 690 SVC003818 TORCH PANEL (IGG&IGM) 2630 3940 3940 3940 3940 3940 SVC003819 TOTAL PROTEIN 200 300 300 300 300 300 SVC003820 TOXOPLASMA IGG ANTIBODY 610 910 910 910 910 910 SVC003821 TPHA 640 960 960 960 960 960 SVC003822 TRACHEAL ASPIRATION FOR C/S 790 1180 1180 1180 1180 1180 SVC003823 TRACHEOSTOMY SECRETIONS FOR C/S 530 800 800 800 800 800 SVC003824 TRACHEOSTOMY SWAB FOR C/S 460 690 690 690 690 690 SVC003825 TRIGLYCERIDES 340 510 510 510 510 510 SVC003826 TROPONIN I 1850 2780 2780 2780 2780 2780 SVC003827 TSH (THYROID STIMULATING HORMONE) 470 710 710 710 710 710 SVC003828 TTG (TISSUE TRANSGLUTAMINASE ) IGA 1160 1740 1740 1740 1740 1740 SVC003833 URIC ACID 200 300 300 300 300 300 SVC003834 URINE FOR AFB SMEAR 210 320 320 320 320 320 SVC003835 URINE FOR ALBUMIN 180 270 270 270 270 270 SVC003836 URINE FOR BJP (BENCE JONES PROTEIN) 580 870 870 870 870 870 SVC003838 URINE FOR BS/BP (BILE SALT & BILE PIGMENT) 170 250 250 250 250 250 SVC003839 URINE FOR CULTURE & SENSITIVITY 850 1280 1280 1280 1280 1280 SVC003840 URINE FOR CYTOLOGY /MALIGNANT CELLS 490 740 740 740 740 740 SVC003841 URINE FOR FUNGAL CULTURE 1110 1670 1670 1670 1670 1670 SVC003842 URINE FOR FUNGAL STAIN 210 320 320 320 320 320 SVC003843 URINE FOR GRAM STAIN 170 250 250 250 250 250 SVC003844 URINE FOR HAEMOGLOBIN 200 300 300 300 300 300 SVC003845 URINE FOR KETONE BODIES 150 230 230 230 230 230 SVC003846 URINE FOR MICROALBUMIN (RANDOM) 580 870 870 870 870 870 SVC003847 URINE FOR PREGNANCY TEST 210 320 320 320 320 320 SVC003848 URINE FOR REDUCING SUBSTANCES 130 190 190 190 190 190 SVC003849 URINE FOR SUGAR 70 110 110 110 110 110 SVC003850 URINE FOR SUGAR (FASTING) 70 110 110 110 110 110 SVC003851 URINE FOR SUGAR (POST PRANDIAL) 70 110 110 110 110 110 SVC003852 URINE FOR SUGAR (RANDOM) 80 120 120 120 120 120 SVC003854 URINE METANEPHRINES (RANDOM) 11340 17010 17010 17010 17010 17010 SVC003855 URINE OSMOLALITY (CALCULATED) 800 1200 1200 1200 1200 1200 SVC003856 URINE POTASSIUM (RANDOM) 280 420 420 420 420 420 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003857 URINE PROTEIN TO CREATININE RATIO 530 800 800 800 800 800 SVC003858 URINE ROUTINE & MICROSCOPY 190 290 290 290 290 290 SVC003859 VACUOLATED EOSINOPHIL COUNT 130 190 190 190 190 190 SVC003860 VAGINAL SWAB FOR C/S 920 1380 1380 1380 1380 1380 SVC003861 VDRL- CSF 240 360 360 360 360 360 SVC003862 VDRL -SERUM 200 300 300 300 300 300 SVC003863 VITAMIN B-12 1300 1950 1950 1950 1950 1950 SVC003864 VITAMIN D 25 HYDROXY 2200 3300 3300 3300 3300 3300 SVC003868 VITREOUS FLUID FOR FUNGAL STAIN 180 270 270 270 270 270 SVC003870 VLDL CHOLESTEROL 260 390 390 390 390 390 SVC003871 WATER FOR CULTURE 1100 1650 1650 1650 1650 1650 SVC003873 WIDAL TEST 310 470 470 470 470 470 SVC003875 WOUND SWAB - HAND FOR C/S 460 690 690 690 690 690 SVC003877 WOUND SWAB FOR AFB STAIN 180 270 270 270 270 270 SVC003878 WOUND SWAB FOR CULTURE & SENSITIVITY 910 1370 1370 1370 1370 1370 SVC003879 WOUND SWAB FOR GRAM STAIN 170 250 250 250 250 250 SVC003880 ALBUMIN TO GLOBULIN (A/G)RATIO 360 540 540 540 540 540 SVC003881 SERUM BICARBONATE LEVEL 690 1040 1040 1040 1040 1040 SVC003882 SERUM TRANSFERRIN 1160 1730 1730 1730 1730 1730 SVC003883 HEPATITIS B SURFACE ANTIBODY(HBSAB) 860 1290 1290 1290 1290 1290 SVC003884 PCR FOR TB (AFB) - QUANTITATIVE 2840 4260 4260 4260 4260 4260 SVC003885 TEC (TOTAL EOSINOPHIL COUNT) 190 280 280 280 280 280 SVC003886 BONE MARROW ASPIRATION REPORTING 560 830 830 830 830 830 SVC003888 MALARIAL PARASITE / MICROFILARIA ( MP/MF ) -BY QBC METHOD 1540 2320 2320 2320 2320 2320 SVC003889 AMMONIA (PLASMA) 1160 1740 1740 1740 1740 1740 SVC003890 OSMOTIC FRAGILITY 510 770 770 770 770 770 SVC003891 17 - HYDROXYPROGESTERONE, NEWBORN SCREEN 260 390 390 390 390 390 SVC003892 17 ALPHA HYDROXY PROGESTERONE 1310 1970 1970 1970 1970 1970 SVC003894 24 HOURS URINE FOR 5HIAA 2780 4170 4170 4170 4170 4170 SVC003895 24 HOURS URINE FOR CORTISOL 840 1260 1260 1260 1260 1260 SVC003896 24 HOURS URINE FOR METANEPHRINES 11340 17010 17010 17010 17010 17010 SVC003897 24 HOURS URINE FOR OXALATE 1790 2690 2690 2690 2690 2690 SVC003898 24 HOURS URINE FOR VMA 3680 5510 5510 5510 5510 5510 SVC003899 24 HOURS URINE FOR CITRATE 920 1380 1380 1380 1380 1380 SVC003900 24 HOURS URINE FOR CREATININE 280 420 420 420 420 420 SVC003901 24 HOURS URINE FOR MAGNESIUM 630 950 950 950 950 950 SVC003903 ABSOLUTE LYMPHOCYTE TEST 170 250 250 250 250 250 SVC003904 ABSOLUTE NEUTROPHIL TEST 170 250 250 250 250 250 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003905 ACETYL CHOLINE RECEPTOR ANTIBODIES (ACHR ABS) 2260 3390 3390 3390 3390 3390 SVC003906 ACID PHOSPHATASE 180 270 270 270 270 270 SVC003907 ACT (ACTIVATED CLOTTING TIME) 170 260 260 260 260 260 SVC003908 ADA (ADENOSINE DEAMINASE - BODY FLUID) 960 1440 1440 1440 1440 1440 SVC003909 ADENO VIRUS IGM 1370 2050 2050 2050 2050 2050 SVC003910 ADENO VIRUS PCR 4200 6300 6300 6300 6300 6300 SVC003911 AFB CULTURE & RADIOMETRIC SUSCEPTIBILITY - 10 DRUG PANEL 10030 15040 15040 15040 15040 15040 SVC003913 AFB CULTURE & RADIOMETRIC SUSCEPTIBILITY - SIREP PANEL 5360 8030 8030 8030 8030 8030 SVC003914 AFB IDENTIFICATION BY NAP 1260 1890 1890 1890 1890 1890 SVC003916 AIR SAMPLING (PER ROOM/OT) 1050 1580 1580 1580 1580 1580 SVC003918 ALDOLASE 720 1090 1090 1090 1090 1090 SVC003919 ALDOSTERONE 1600 2400 2400 2400 2400 2400 SVC003920 ALPHA - 1 ANTITRYPSIN 1940 2910 2910 2910 2910 2910 SVC003921 ALPHA - 1 ANTITRYPSIN PHENOTYPE 7720 11580 11580 11580 11580 11580 SVC003922 AMINO ACIDS, ORGANIC ACIDS, FATTY ACIDS DISORDERS (TANDEM MASS SPECTROMETRY)3150 4730 4730 4730 4730 4730 SVC003924 AMOEBIC SEROLOGY (ENTAMOEBA HISTOLYTICA ANTIBODIES) 1950 2930 2930 2930 2930 2930 SVC003925 ANAEROBIC CULTURE 1260 1890 1890 1890 1890 1890 SVC003927 ANTI - CARDIOLIPIN ANTIBODY (ANTI - PHOSPHOLIPID) IGM 820 1230 1230 1230 1230 1230 SVC003928 ANTI - GBM ANTIBODIES 1520 2280 2280 2280 2280 2280 SVC003929 ANTI - HBS TITRE 950 1430 1430 1430 1430 1430 SVC003930 ANTI - L/P (LIVER/PANCREAS) 2150 3230 3230 3230 3230 3230 SVC003931 ANTI A TITER 440 660 660 660 660 660 SVC003932 ANTI B TITER 470 710 710 710 710 710 SVC003933 ANTI CCP ANTIBODY 2030 3050 3050 3050 3050 3050 SVC003934 ANTI CENTROMERE ANTIBODIES 1420 2130 2130 2130 2130 2130 SVC003935 ANTI INTRINSIC FACTOR IGG 2150 3230 3230 3230 3230 3230 SVC003936 ANTI NUCLEAR ANTIBODY (ANA) (ELISA) 700 1050 1050 1050 1050 1050 SVC003937 ANTI NUCLEAR ANTIBODY PROFILE (ANA PROFILE) 1000 1500 1500 1500 1500 1500 SVC003938 ANTI PARIETAL ANTIBODY 1630 2440 2440 2440 2440 2440 SVC003941 ANTI RNP SM IGG 1680 2520 2520 2520 2520 2520 SVC003942 ANTITHROMBIN III (AT3) 14500 21750 21750 21750 21750 21750 SVC003943 ANTI THYROGLOBULIN ANTIBODY(ANTI TG) 1300 1950 1950 1950 1950 1950 SVC003944 ANTI XA ACTIVITY 3100 4650 4650 4650 4650 4650 SVC003947 APCR (ACTIVATED PROTEIN C RESISTANT) 4100 6140 6140 6140 6140 6140 SVC003949 ASCA IGA (ANTI SACCHOROMYCES CEREVISIAE ANTIBODIES) 1540 2320 2320 2320 2320 2320 SVC003950 ASCA IGG (ANTI SACCHOROMYCES CEREVISIAE ANTIBODIES) 1470 2210 2210 2210 2210 2210 SVC003951 ASPERGILLUS ANTIBODIES (IGM & IGG) 3200 4800 4800 4800 4800 4800 SVC003952 ASPERGILLUS ANTIBODIES IGG 1790 2680 2680 2680 2680 2680 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC003954 ASPIRATATED FLUID (CLINICAL PATHOLOGY) 140 200 200 200 200 200 SVC003955 AXILLARY SWAB FOR C/S 1050 1580 1580 1580 1580 1580 SVC003956 BAL FOR PCP 150 2400 3600 3600 3600 3600 3600 SVC003957 BENZODIAZEPINES SCREEN - URINE 740 1100 1100 1100 1100 1100 SVC003959 BETA 2 MICROGLOBULIN 1300 1950 1950 1950 1950 1950 SVC003961 BLEEDING TIME (BT) 230 350 350 350 350 350 SVC003962 BLOCK FOR SPECIAL STAIN 230 350 350 350 350 350 SVC003963 BLOOD CROSS MATCHING 450 680 680 680 680 680 SVC003964 BLOOD GROUP & RH TYPING 200 300 300 300 300 300 SVC003965 BLOOD TRANSFUSION CHARGES (DAY CARE) 410 610 610 610 610 610 SVC003966 BRAIN NATRIURETIC PEPTIDE (BNP) 1790 2680 2680 2680 2680 2680 SVC003967 BONE MARROW FOR C/S 1210 1810 1810 1810 1810 1810 SVC003968 BONE PIECE FOR C/S 1050 1580 1580 1580 1580 1580 SVC003969 BONE SPECIMEN 1260 1890 1890 1890 1890 1890 SVC003971 BREAST PANEL (ER, PR, HER II NEU) 3800 5700 5700 5700 5700 5700 SVC003972 BRUCELLA AGGLUTINATION TEST 700 1050 1050 1050 1050 1050 SVC003973 BRUCELLA ANTIBODIES (IGM & IGG) 1850 2780 2780 2780 2780 2780 SVC003974 C PEPTIDE 1160 1740 1740 1740 1740 1740 SVC003975 C1 ESTERASE INHIBITOR PROTEIN QUANTITATION 2310 3470 3470 3470 3470 3470 SVC003976 CALCITONIN 2260 3390 3390 3390 3390 3390 SVC003977 CD 34 2420 3620 3620 3620 3620 3620 SVC003979 CD 55 1520 2280 2280 2280 2280 2280 SVC003980 CD 59 1520 2280 2280 2280 2280 2280 SVC003982 CD3 2150 3230 3230 3230 3230 3230 SVC003983 CD4/CD8 2510 3760 3760 3760 3760 3760 SVC003985 CELIAC PROFILE (TTG IGA ANTIBODY ,GLIADIN IGG & IGA) 3310 4960 4960 4960 4960 4960 SVC003987 CHLAMYDIA ANTIGEN DETECTION 2100 3150 3150 3150 3150 3150 SVC003992 CHLAMYDIA TRACHOMATIS ANTIBODIES IGG 5930 8900 8900 8900 8900 8900 SVC003994 CHROMOGRANIN A 7590 11390 11390 11390 11390 11390 SVC003995 CHROMOSOMAL BREAKAGE STUDY (MYTOMYCIN INDUCED) 6300 9450 9450 9450 9450 9450 SVC003996 CLOSTRIDIUM DIFFICILE TOXIN A & B 2840 4260 4260 4260 4260 4260 SVC003997 CLOTTING TIME (CT) 240 360 360 360 360 360 SVC003998 CLPD - PANEL 10400 15590 15590 15590 15590 15590 SVC003999 CMV IGM & IGG ANTIBODIES 1160 1740 1740 1740 1740 1740 SVC004000 CMV IGM ANTIBODY (CYTOMEGALOVIRUS) 580 870 870 870 870 870 SVC004001 COAGGLUTINATION TEST 320 470 470 470 470 470 SVC004002 COXSACKIE VIRUS ANTIBODY (IGM & IGG) 3260 4880 4880 4880 4880 4880 SVC004003 CREATININE CLEARANCE 530 790 790 790 790 790 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC004004 CRYOGLOBULINS - QUALITATIVE 1000 1500 1500 1500 1500 1500 SVC004005 CRYPTOCOCCUS ANTIGEN 2100 3150 3150 3150 3150 3150 SVC004006 CSF - OLIGOCLONAL BAND 4730 7100 7100 7100 7100 7100 SVC004007 CSF & SERUM PROTEIN ELECTROPHORESIS / OLIGOCLONAL BANDS 4410 6620 6620 6620 6620 6620 SVC004008 CSF ANALYSIS (CLINICAL PATHOLOGY) 440 660 660 660 660 660 SVC004011 CSF FOR MENINGOCOCCAL AG 2100 3150 3150 3150 3150 3150 SVC004013 CSF FOR TB - PCR 2400 3600 3600 3600 3600 3600 SVC004014 CSF GRAM STAIN 350 520 520 520 520 520 SVC004017 CULTURE AFB ANTIBIOTIC SENSITIVITY - 5 DRUG PANEL 6300 9450 9450 9450 9450 9450 SVC004019 CYSTATIN C 1470 2210 2210 2210 2210 2210 SVC004021 CYSTICERCUS ANTIBODIES IGG 1300 1950 1950 1950 1950 1950 SVC004022 CYTOGENETICS 3470 5200 5200 5200 5200 5200 SVC004023 KARYOTYPING 2840 4250 4250 4250 4250 4250 SVC004024 CYTOGENETICS (KARYOTYPING) + FISH 3200 4800 4800 4800 4800 4800 SVC004026 DENGUE IGG ANTIBODIES 600 600 600 600 600 600 SVC004028 DENGUE IGM ANTIBODIES 600 600 600 600 600 600 SVC004031 DNA - BETA - THALASSEMIA [5 COMMON MUTATION] + HBE 19430 29140 29140 29140 29140 29140 SVC004037 DRAIN FLUID FOR AMYLASE 790 1180 1180 1180 1180 1180 SVC004038 DRAIN FLUID FOR BILIRUBIN 270 410 410 410 410 410 SVC004039 DRAIN FLUID FOR CREATININE 140 200 200 200 200 200 SVC004040 EBV (EA) IGG ANTIBODY 3150 4730 4730 4730 4730 4730 SVC004041 EBV (NA) IGG ANTIBODY 2050 3080 3080 3080 3080 3080 SVC004042 EBV (NA) IGM ANTIBODY 2200 3300 3300 3300 3300 3300 SVC004043 EBV (VCA) IGG ANTIBODY 1760 2640 2640 2640 2640 2640 SVC004044 EBV (VCA) IGM ANTIBODY 1850 2780 2780 2780 2780 2780 SVC004045 ENDOMYSIAL IGA ANTIBODY 1790 2680 2680 2680 2680 2680 SVC004046 ERYTHROPOIETIN 2210 3320 3320 3320 3320 3320 SVC004047 EXTRA SLIDE (PER SLIDE) 570 860 860 860 860 860 SVC004050 FACTOR V LEIDEN MUTATION ANALYSIS 5500 8250 8250 8250 8250 8250 SVC004051 FETAL AUTOPSY 2100 3150 3150 3150 3150 3150 SVC004052 FILARIA ANTIGEN (BLOOD) 790 1190 1190 1190 1190 1190 SVC004053 FISH - FLUORSCENCE IN SITU HYBRIDIZATION 8510 12760 12760 12760 12760 12760 SVC004054 FLT3 MUTATION 3360 5040 5040 5040 5040 5040 SVC004055 FLUID FOR CHOLESTEROL 150 220 220 220 220 220 SVC004056 FLUID FOR FAT GLOBULES 160 240 240 240 240 240 SVC004057 FLUID FOR TRIGLYCERIDES 340 500 500 500 500 500 SVC004058 FREE PSA 890 1340 1340 1340 1340 1340 SVC004059 FROZEN SECTION 960 1440 1440 1440 1440 1440 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC004061 G - 6 - PD, NEWBORN SCREEN 260 390 390 390 390 390 SVC004062 GAD - 65 ANTIBODIES (GLUTAMIC ACID DECARBOXYLASE) 6510 9770 9770 9770 9770 9770 SVC004063 GALACTOSEMIA (EPIMERASE), QUANTITATIVE, BLOOD 2570 3860 3860 3860 3860 3860 SVC004070 GCT (GLUCOSE CHALLENGE TEST) 100 150 150 150 150 150 SVC004071 GLUTAMIC ACID DECARBOXYLASE - 65 IGG 6510 9770 9770 9770 9770 9770 SVC004074 GROWTH HORMONE 790 1190 1190 1190 1190 1190 SVC004075 GROWTH HORMONE STIMULATION TEST 3310 4960 4960 4960 4960 4960 SVC004076 H1N1 4500 4500 4500 4500 4500 4500 SVC004077 HAMS TEST 1260 1890 1890 1890 1890 1890 SVC004078 HANTA VIRUS IG M ANTIBODIES 1050 1580 1580 1580 1580 1580 SVC004079 HBSAG (HEPATITS B SURFACE ANTIGEN) - ELISA 1540 2310 2310 2310 2310 2310 SVC004080 HBSAG (RIBA) CONFIMATORY 3830 5750 5750 5750 5750 5750 SVC004082 HCV - RIBA (HCV CONFIRMATORY) 2780 4170 4170 4170 4170 4170 SVC004083 HCV (ANTI HCV ANTIBODY) - ELISA 1680 2520 2520 2520 2520 2520 SVC004084 HCV GENOTYPING 4730 7100 7100 7100 7100 7100 SVC004086 HELICOBACTER PYLORI - IGA & IGG 3260 4880 4880 4880 4880 4880 SVC004087 HELICOBACTER PYLORI - IGM 1840 2760 2760 2760 2760 2760 SVC004088 HELICOBACTER PYLORI ANTIBODIES IGA 2730 4100 4100 4100 4100 4100 SVC004089 HEMOGLOBIN HPLC 1100 1650 1650 1650 1650 1650 SVC004090 HEMOPARASITES - BY QBC METHOD 240 360 360 360 360 360 SVC004092 HEPATITIS DELTA VIRUS (HDV) TOTAL ANTIBODIES 2470 3700 3700 3700 3700 3700 SVC004093 HEPATITIS E VIRUS IGG 1580 2370 2370 2370 2370 2370 SVC004094 HEPATITIS E VIRUS IGM 1600 2400 2400 2400 2400 2400 SVC004096 HER2 / FISH 11000 16500 16500 16500 16500 16500 SVC004097 HIT ANTIBODIES (HEPARIN INDUCED THROMBOCYTOPENIA) 2840 4250 4250 4250 4250 4250 SVC004098 HIV - ELISA 510 770 770 770 770 770 SVC004099 HIV 1 & 2 ANTIBODIES 590 880 880 880 880 880 SVC004100 HIV P24 ANTIGEN 600 900 900 900 900 900 SVC004101 HIV VIRAL LOAD 5250 7880 7880 7880 7880 7880 SVC004102 HLA TISSUE TYPING 13970 20950 20950 20950 20950 20950 SVC004103 HLA - B5 4520 6770 6770 6770 6770 6770 SVC004104 HLA AB & DR TISSUE CROSS MATCHING 3520 5280 5280 5280 5280 5280 SVC004105 HOMOVANILLIC ACID (HVA), 24 - HOUR URINE 8400 12600 12600 12600 12600 12600 SVC004108 HPE HISTOPATHOLOGICAL EXAM SMALL SPECIMEN 630 950 950 950 950 950 SVC004109 HPV TESTING IN CERVICAL SMEAR 2210 3310 3310 3310 3310 3310 SVC004110 HSV 1 & 2 IGG ANTIBODIES 1200 1800 1800 1800 1800 1800 SVC004111 HSV 1 & 2 IGM ANTIBODIES 1420 2130 2130 2130 2130 2130 SVC004113 HYDATID ANTIBODIES 1420 2130 2130 2130 2130 2130 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC004118 IGF BINDING PROTEIN - 3 4250 6380 6380 6380 6380 6380 SVC004119 IGF1 (INSULIN GROWTH FACTOR - 1) 4500 6750 6750 6750 6750 6750 SVC004120 IMATINIB RESISTANCE MUTATION ANALYSIS (IRMA) 8190 12290 12290 12290 12290 12290 SVC004121 IMMUNOFIXATION ELECTROPHORESIS (IFE), SERUM 7160 10740 10740 10740 10740 10740 SVC004122 IMMUNOFIXATION ELECTROPHORESIS, 24 - HOUR URINE 8400 12600 12600 12600 12600 12600 SVC004123 IMMUNOFLUORSCENCE - BIOPSY 2570 3860 3860 3860 3860 3860 SVC004124 IMMUNOPHENOTYPING - 5 PANEL 4310 6460 6460 6460 6460 6460 SVC004125 IMMUNOPHENOTYPING - 7 PANEL 5460 8190 8190 8190 8190 8190 SVC004127 INSULIN (FASTING) 920 1380 1380 1380 1380 1380 SVC004128 INSULIN (POST PRANDIAL) 920 1380 1380 1380 1380 1380 SVC004129 INTRINSIC FACTOR ANTIBODY 2520 3780 3780 3780 3780 3780 SVC004130 ISLET CELL ANTIBODY 1800 2700 2700 2700 2700 2700 SVC004131 JAK - 2 6120 9180 9180 9180 9180 9180 SVC004132 JAPANESE ENCEPHALITIS VIRUS (JE VIRUS) - CSF 7510 11260 11260 11260 11260 11260 SVC004133 JAPANESE ENCEPHALITIS VIRUS (JE VIRUS) - SERUM 47880 71820 71820 71820 71820 71820 SVC004134 KAPPA/LAMBDA LIGHT CHAIN 6500 9750 9750 9750 9750 9750 SVC004135 LAP SCORE (LEUCOCYTE ALKALINE PHOSPHATASE SCORE) 830 1250 1250 1250 1250 1250 SVC004136 LE CELLS 370 550 550 550 550 550 SVC004137 LEAD TEST 1680 2520 2520 2520 2520 2520 SVC004138 LEGIONELLA PNEUMOMIA ANTIBODIES (IGM & IGG) 8900 13360 13360 13360 13360 13360 SVC004141 LEPTOSPIRA (IGM) ANTIBODY 1420 2130 2130 2130 2130 2130 SVC004142 LEUKODEPLETION FILTER FOR PLATELETS 1210 1810 1810 1810 1810 1810 SVC004144 LN BIOPSY 2470 3700 3700 3700 3700 3700 SVC004146 LUPUS ANTICOAGULANT 1700 2550 2550 2550 2550 2550 SVC004151 LYMPHOMA PANEL 2890 4330 4330 4330 4330 4330 SVC004152 MALARIAL ANTIGEN 760 1140 1140 1140 1140 1140 SVC004154 MEASLES ANTIBODIES (IGM & IGG) 3150 4730 4730 4730 4730 4730 SVC004155 MEASLES IGG ANTIBODIES 1680 2520 2520 2520 2520 2520 SVC004158 METHAEMOGLOBIN 370 550 550 550 550 550 SVC004159 MICRO FILARIA (SMEAR) 210 320 320 320 320 320 SVC004162 MUMPS ANTIBODIES (IGM & IGG) 2570 3860 3860 3860 3860 3860 SVC004163 MUMPS IGG ANTIBODIES 1680 2520 2520 2520 2520 2520 SVC004164 MUMPS IGM ANTIBODIES 1760 2650 2650 2650 2650 2650 SVC004166 MYCOBACTERIUM TUBERCULOSIS ANTIBODY IGA 970 1450 1450 1450 1450 1450 SVC004167 MYCOPLASMA PNEUMONIAE ANTIBODIES (IGM & IGG) 3780 5670 5670 5670 5670 5670 SVC004169 MYCOPLASMA PNEUMONIAE ANTIBODY IGM 2100 3150 3150 3150 3150 3150 SVC004176 NEURON SPECIFIC ENOLASE (NSE) 1630 2440 2440 2440 2440 2440 SVC004177 NEWBORN SCREENING PANEL 5 1470 2210 2210 2210 2210 2210 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC004178 NEWBORN SCREENING, EXTENDED BIOTINIDASE CYSTIC FIBROSIS 4150 6220 6220 6220 6220 6220 SVC004180 NITROBLUE TETRAZOLIUM 1790 2680 2680 2680 2680 2680 SVC004182 PARVOVIRUS B 19 ANTIBODIES (IGM & IGG) 4780 7170 7170 7170 7170 7170 SVC004185 PAUL BUNNELL TEST (INFECTIOUS MONONUCLEOSIS) 1160 1730 1730 1730 1730 1730 SVC004186 PCR FOR CYTOMEGALOVIRUS - QUALITATIVE 4310 6460 6460 6460 6460 6460 SVC004187 PCR FOR CYTOMEGALOVIRUS - QUANTIFICATION 13860 20790 20790 20790 20790 20790 SVC004188 PCR FOR EBV - DNA - QUANTITATIVE 3100 4650 4650 4650 4650 4650 SVC004189 PCR FOR EBV - DNA - QUALITATIVE 4410 6620 6620 6620 6620 6620 SVC004190 PCR FOR EU BACTERIAL - QUALITATIVE 2260 3390 3390 3390 3390 3390 SVC004191 PCR FOR HCV RNA - QUALITATIVE 4520 6780 6780 6780 6780 6780 SVC004192 PCR FOR HCV RNA - QUANTIFICATION 15750 23630 23630 23630 23630 23630 SVC004193 PCR FOR HIV - QUALITATIVE 3990 5990 5990 5990 5990 5990 SVC004194 HERPES SIMPLEX VIRUS (HSV) TYPE 1, PCR, QUALITATIVE 3890 5830 5830 5830 5830 5830 SVC004195 PCR FOR HSV - QUANTIFICATION 4670 7010 7010 7010 7010 7010 SVC004196 PCR FOR PAN FUNGAL - QUALITATIVE 2470 3700 3700 3700 3700 3700 SVC004198 PCR FOR TB (AFB) - QUALITATIVE 2000 3000 3000 3000 3000 3000 SVC004199 PCR FOR TOXOPLASMA GONDII 1840 2760 2760 2760 2760 2760 SVC004201 PERICARDIAL FLUID AFB CULTURE FOR (BACTEC METHOD) 1470 2210 2210 2210 2210 2210 SVC004202 PERICARDIAL FLUID FOR TB - PCR 2680 4020 4020 4020 4020 4020 SVC004203 PERITONEAL FLUID FOR ANAEROBIC C/S 1050 1580 1580 1580 1580 1580 SVC004204 PERITONEAL / ASCITIC FLUID - CLINICAL PATHOLOGY 170 260 260 260 260 260 SVC004205 PERITONEAL FLUID FOR AFB CULTURE (BACTEC METHOD) 1160 1730 1730 1730 1730 1730 SVC004207 PLASMA AMINO ACIDO GRAM 1050 1580 1580 1580 1580 1580 SVC004208 PLASMA FREE HAEMOGLOBIN 190 280 280 280 280 280 SVC004209 BLOOD LEAD LEVEL 1730 2600 2600 2600 2600 2600 SVC004210 PLASMA RENIN 5460 8190 8190 8190 8190 8190 SVC004211 PLATELET FUNCTION TEST 5090 7640 7640 7640 7640 7640 SVC004212 PLATELET RICH PLASMA 700 1060 1060 1060 1060 1060 SVC004215 PLEURAL FLUID - TBPCR 2000 3000 3000 3000 3000 3000 SVC004216 PLEURAL FLUID AFB CULTURE FOR (BACTEC METHOD) 1730 2600 2600 2600 2600 2600 SVC004217 PORPHOBILINOGEN (PBG), QUALITATIVE, URINE 3680 5520 5520 5520 5520 5520 SVC004219 PORPHYRINS TOTAL, QUALITATIVE, RANDOM URINE 5670 8510 8510 8510 8510 8510 SVC004220 PROCALCITONIN (PCT) 3730 5600 5600 5600 5600 5600 SVC004221 PROTEIN C 3950 5930 5930 5930 5930 5930 SVC004222 PROTEIN ELECTROPHORESIS 790 1190 1190 1190 1190 1190 SVC004223 PROTEIN ELECTROPHORESIS & IFE 710 1070 1070 1070 1070 1070 SVC004224 PROTEIN ELECTROPHORESIS, 24 - HOUR URINE DOES NOT INCLUDE IFE. 5850 8770 8770 8770 8770 8770 SVC004225 PROTEIN S 3300 4950 4950 4950 4950 4950 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC004226 PUS FOR AEROBIC C/S 790 1180 1180 1180 1180 1180 SVC004227 RABIES ANTIBODIES 2310 3470 3470 3470 3470 3470 SVC004228 CHOLESTEROL /HDL RATIO 560 840 840 840 840 840 SVC004229 RANDOM URINE MAGNESIUM 630 950 950 950 950 950 SVC004231 RANDOM URINE POTASSIUM 280 420 420 420 420 420 SVC004232 RANDOM URINE SODIUM 310 470 470 470 470 470 SVC004233 RED CELL FOLATE (RBC FOLATE) 2210 3310 3310 3310 3310 3310 SVC004234 REGULAR HP EXTRA LARGE SPECIMEN 3310 4970 4970 4970 4970 4970 SVC004235 REGULAR HP MEDIUM SPECIMEN 2100 3150 3150 3150 3150 3150 SVC004236 RT - PCR FOR HIV 3680 5510 5510 5510 5510 5510 SVC004237 RT PCR FOR BCR - ABL QUALITATIVE 3260 4890 4890 4890 4890 4890 SVC004238 RT PCR FOR BCR - ABL QUANTITATIVE 6300 9450 9450 9450 9450 9450 SVC004239 RT PCR QUANTITATIVE FOR PML / RARA TRANSLOCATION 5460 8190 8190 8190 8190 8190 SVC004240 RUBELLA ANTIBODIES (IGM & IGG) 1160 1730 1730 1730 1730 1730 SVC004241 RUBELLA IGM ANTIBODY 600 900 900 900 900 900 SVC004242 SABACEOUS - CYST FOR HISTOPATHOLOGY 370 550 550 550 550 550 SVC004245 SERUM ANTI PARIETAL/ANTI INTRINSIC FACTOR (IF) 3260 4880 4880 4880 4880 4880 SVC004246 SERUM ASPERGILLUS GALACTOMANNAN AG 5630 8440 8440 8440 8440 8440 SVC004247 SERUM COPPER 1370 2060 2060 2060 2060 2060 SVC004248 SERUM FREE LIGHT CHAIN ASSAY 8450 12680 12680 12680 12680 12680 SVC004249 SERUM GASTRIN 1430 2150 2150 2150 2150 2150 SVC004250 SERUM INSULIN 840 1260 1260 1260 1260 1260 SVC004251 SERUM LEPTIN 4100 6140 6140 6140 6140 6140 SVC004252 SERUM MYOGLOBIN 4200 6300 6300 6300 6300 6300 SVC004253 SERUM OXALATE 790 1180 1180 1180 1180 1180 SVC004254 SERUM PYRUVATE 3410 5120 5120 5120 5120 5120 SVC004256 SERUM ZINC 1800 2700 2700 2700 2700 2700 SVC004257 SEX HORMONE BINDING GLOBULIN (SHBG) 2470 3710 3710 3710 3710 3710 SVC004259 SKIN SCRAPPING FOR KOH PREPARATION 130 190 190 190 190 190 SVC004260 SLIDE & BLOCK FOR REVIEW 610 920 920 920 920 920 SVC004261 SLIDE FOR REVIEW 740 1100 1100 1100 1100 1100 SVC004262 SLIT SKIN SMEAR FOR M.LEPRAE 250 380 380 380 380 380 SVC004263 SPUTUM FOR .AFB CULTURE - (BACTEC METHOD) 1050 1580 1580 1580 1580 1580 SVC004264 SPUTUM FOR AFB CULTURE - (LJ METHOD) 800 1200 1200 1200 1200 1200 SVC004265 SPUTUM FOR MYCOBACTERIAL CULTURE - (BACTEC METHOD) 1050 1580 1580 1580 1580 1580 SVC004266 SPUTUM FOR PCP 2520 3780 3780 3780 3780 3780 SVC004267 STONE FOR ANALYSIS (CALCULUS FOR BIOCHEMICAL EXAM) 1050 1580 1580 1580 1580 1580 SVC004269 SYNOVIAL FLUID FOR ANALYSIS (CLINICAL PATHOLOGY) 900 1350 1350 1350 1350 1350 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC004270 SYNOVIAL FLUID FOR TB - PCR 3200 4800 4800 4800 4800 4800 SVC004271 TRI IODO THYRONINE (T3) 210 320 320 320 320 320 SVC004272 THYROXINE (T4) 240 360 360 360 360 360 SVC004273 TACROLIMUS 3780 3780 3780 3780 3780 3780 SVC004274 THYROGLOBULIN 1790 2680 2680 2680 2680 2680 SVC004275 TISSUE FOR ANAEROBIC C/S 1100 1650 1650 1650 1650 1650 SVC004276 TOXOPLASMA IGM & IGG ANTIBODIES 1050 1580 1580 1580 1580 1580 SVC004277 TOXOPLASMA IGM ANTIBODY 610 910 910 910 910 910 SVC004278 ANTI-TPO (THYROPEROXIDASE) ANTIBODY 1500 2250 2250 2250 2250 2250 SVC004279 TRACHEAL SECRECTION FOR PCP 170 250 250 250 250 250 SVC004280 TRIPLE MARKER (MATERNAL SCREEN -AFP, BETA HCG, FREE ESTRIOL) 2700 4050 4050 4050 4050 4050 SVC004281 TROPONIN T - CARDIAC MARKER 1530 2300 2300 2300 2300 2300 SVC004282 TSH, NEWBORN SCREEN 260 390 390 390 390 390 SVC004283 TZANCK SMEAR 220 330 330 330 330 330 SVC004284 URINE / PLASMA DARK FIELD MICROSCOPY FOR LEPTOSPIRA 120 170 170 170 170 170 SVC004285 URINE FOR AFB CULTURE - (BACTEC METHOD) 1050 1580 1580 1580 1580 1580 SVC004286 URINE FOR AMINO ACIDO GRAM 8450 12680 12680 12680 12680 12680 SVC004287 URINE FOR HUMAN CHORIONIC GONADOTROPIN (HCG) 1110 1110 1110 1110 1110 1110 SVC004288 URINE FOR EOSINOPHILS 180 270 270 270 270 270 SVC004289 URINE FOR FAT GLOBULES 40 60 60 60 60 60 SVC004290 URINE FOR HAEMOSIDERIN 370 550 550 550 550 550 SVC004291 URINE FOR MICROALBUMIN TO CREATININE RATIO 650 980 980 980 980 980 SVC004292 URINE FOR MYOGLOBIN 1010 1510 1510 1510 1510 1510 SVC004293 URINE FOR PH 180 270 270 270 270 270 SVC004294 URINE FOR PORPHOBILINOGEN 4360 6540 6540 6540 6540 6540 SVC004295 URINE FOR PROTIEN ELECTROPHORESIS 3900 5850 5850 5850 5850 5850 SVC004296 URINE FOR SPECIFIC GRAVITY 140 200 200 200 200 200 SVC004297 URINE FOR TOXICOLOGY SCREENING 4000 6000 6000 6000 6000 6000 SVC004298 URINE PORPHYRIA - RANDOM / 24 HRS. 3520 5280 5280 5280 5280 5280 SVC004299 URINE TBPCR 3310 4960 4960 4960 4960 4960 SVC004300 VALPROIC ACID 840 1260 1260 1260 1260 1260 SVC004301 VANCOMYCIN 4750 7130 7130 7130 7130 7130 SVC004302 VARICELLA ANTIBODIES (IGM & IGG) 2210 3320 3320 3320 3320 3320 SVC004303 VARICELLA IGG ANTIBODY 1240 1860 1860 1860 1860 1860 SVC004304 VARICELLA ZOSTER IGM 1260 1890 1890 1890 1890 1890 SVC004305 VITAMIN A (RETINOL) 4200 6300 6300 6300 6300 6300 SVC004306 VITAMIN B6 2150 3230 3230 3230 3230 3230 SVC004307 VITAMIN D 1,25 DIHYDROXY (VITAMIN D3) 3700 5550 5550 5550 5550 5550 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC004308 VWF (VON WILLIBRANDS ANTIGEN) 10500 15750 15750 15750 15750 15750 SVC004309 WEIL FELIX TEST 930 1400 1400 1400 1400 1400 SVC004310 WESTERN BLOT (HIV CONFIRMATORY) 3350 5030 5030 5030 5030 5030 SVC004311 XYTON FOR ENCEPHALITIS PCR 13440 20160 20160 20160 20160 20160 SVC004315 TRANSFUSION PACKED CELLS 320 470 470 470 470 470 SVC004316 TRANSFUSION PLATELET 210 320 320 320 320 320 SVC004317 PERIPHERAL BLOOD STEM CELL COLLECTION (PBSC) WITH CRYOPRESERVATION 28560 42840 42840 42840 42840 42840 SVC004318 ANTITHYROID PEROXIDASE ANTIBODY 1370 2050 2050 2050 2050 2050 SVC004320 VITAMIN D 25 HYDROXY (VITAMIN D TOTAL) 1900 2850 2850 2850 2850 2850 SVC004322 CHIKUNGUNYA VIRUS ANTIBODY - IGM 630 950 950 950 950 950 SVC004324 MATERNAL SERUM SCREEN 2 (DUAL TEST) 2490 3740 3740 3740 3740 3740 SVC004325 FREE BETA HUMAN CHORIONIC GONADOTROPIN (HCG) 720 1090 1090 1090 1090 1090 SVC004326 RANDOM URINE UREA NITROGEN 260 390 390 390 390 390 SVC004330 FISH FOR MULTIPLE MYELOMA INCLUDING DEL 17P 13440 20160 20160 20160 20160 20160 SVC004337 ALLERGY MARKER-ASPERGILLUS FUMIGATUS 1160 1730 1730 1730 1730 1730 SVC004372 ALLERGY MARKER-GLUTEN 1890 2840 2840 2840 2840 2840 SVC004428 ALLERGY MARKER FOR ANIMAL PANEL 4200 6300 6300 6300 6300 6300 SVC004430 ALLERGY MARKER FOR DUST PANEL 3680 5510 5510 5510 5510 5510 SVC004432 ALLERGY MARKER FOR FOOD PANEL 6830 10240 10240 10240 10240 10240 SVC004435 ALLERGY MARKER FOR MOLD PANEL 4200 6300 6300 6300 6300 6300 SVC004436 ALLERGY- NON VEGETARIAN PANEL 4730 7090 7090 7090 7090 7090 SVC004438 ALLERGY- PULSES PANEL 3150 4730 4730 4730 4730 4730 SVC004439 ALLERGY MARKER FOR TREE PANEL 4730 7090 7090 7090 7090 7090 SVC004444 ALLERGY-WHEEZE / RHINITIS PANEL,PEDIATRIC 11030 16540 16540 16540 16540 16540 SVC004445 ALLERGY SCREEN 1680 2520 2520 2520 2520 2520 SVC004446 ALLERGY POST SCREEN PROFILE 12080 18110 18110 18110 18110 18110 SVC004447 COMPREHENSIVE ALLERGY PROFILE 13650 20480 20480 20480 20480 20480 SVC004448 LIPOPROTEIN (A) 1020 1530 1530 1530 1530 1530 SVC004450 ACUTE LEUKEMIA COMPREHENSIVE DIAGNOSTIC PANEL (ALCD PANEL) 26250 39380 39380 39380 39380 39380 SVC004451 LEPTOSPIRA ANTIBODY IGG 1420 2130 2130 2130 2130 2130 SVC004452 TROPHOBLASTIC CANCER MARKER-BETA HCG 600 900 900 900 900 900 SVC004453 CULTURE AND SENSITIVITY FOR BIOLOGICAL INDICATOR 870 1310 1310 1310 1310 1310 SVC004455 SERUM FOR BETA 2 GYLCOPROTEIN SCREEN (IGG, IGM, IGA) 2730 4100 4100 4100 4100 4100 SVC004456 EPIDERMAL GROWTH FACTOR RECEPTOR MUTATION ANAYLSIS 2000 2990 2990 2990 2990 2990 SVC004457 URINE FOR ORGANIC ACID (GC/MS) 3680 5510 5510 5510 5510 5510 SVC004458 COMPREHENSIVE CHRONIC LYMHOCYTIC LEUKEMIA (CLL) PANEL FOR MINIMAL11760 RESIDUAL17640 DISEASE (MRD)17640 17640 17640 17640 SVC004459 IMMUNE DEFICIENCY PANEL 2520 3780 3780 3780 3780 3780 SVC004463 IHC 2-3 MARKERS 4500 6750 6750 6750 6750 6750 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC004464 IHC SINGLE MARKER 2200 3300 3300 3300 3300 3300 SVC004465 IHC 4 MARKERS 6090 9140 9140 9140 9140 9140 SVC004466 CRP (C -REACTIVE PROTEIN) HS 920 1380 1380 1380 1380 1380 SVC004467 2-HOURS POSTLOAD (75 GM) GLUCOSE 170 250 250 250 250 250 SVC004470 CYTOGENETICS (KARYOTYPING) 2840 4250 4250 4250 4250 4250 SVC004471 RANDOM URINE FOR CALCIUM-CREATININE RATIO 500 760 760 760 760 760 SVC004472 24 HOURS URINE FOR CALCIUM-CREATININE RATIO 450 680 680 680 680 680 SVC004473 INSULIN ANTIBODIES 2100 3150 3150 3150 3150 3150 SVC004474 SERUM FOR ANDROSTENEDIONE 2970 2970 2970 2970 2970 2970 SVC004475 HERPES SIMPLEX VIRUS (HSV) TYPE 2, PCR, QUALITATIVE 3890 5830 5830 5830 5830 5830 SVC004476 HERPES SIMPLEX VIRUS (HSV) TYPE 1 & 2, PCR, QUALITATIVE 6410 9610 9610 9610 9610 9610 SVC004479 SERUM FOR NMO 4 ANTIBODIES (AQUAPORINE 4 ANTIBODIES) 6830 10240 10240 10240 10240 10240 SVC004480 WHOLE BLOOD FOR ALCD AND MRD 840 1260 1260 1260 1260 1260 SVC004501 DUCHENNE MUSCULAR DYSTROPHY (DMD ) DELETION/DUPLICATION ANALYSIS9870 BY MLPA14810 ( 79 EXONS ) 14810 14810 14810 14810 SVC004510 FRAGILE X SYNDROME ( METHYLATION TEST - CONFIRMATORY ) 6140 9210 9210 9210 9210 9210 SVC004511 SCREENING OF FRAGILE X SYNDROME(PCR BASED) 3100 4650 4650 4650 4650 4650 SVC004544 SPINAL CEREBELLAR ATAXIA ( SCA ) - ONE GENE 4410 6620 6620 6620 6620 6620 SVC004553 ALPHA GLUCOSIDASE ENZYME ASSAY FOR POMPE DISEASE 4830 7250 7250 7250 7250 7250 SVC004554 URINE FOR AMINO ACID CHROMATOGRAPHY(QUALITATIVE) 2100 3150 3150 3150 3150 3150 SVC004556 ENZYME ASSAY FOR ARYL SULPHATASE A (METACHROMATIC LEUKODYSTROPHY)3360 5040 5040 5040 5040 5040 SVC004561 KRABBE DISEASE - GALACTOCEREBROSIDASE ENZYME ASSAY 4410 6620 6620 6620 6620 6620 SVC004562 AMINO ACID ASSAY-QUANTITATIVE( HPLC ) 5990 8980 8980 8980 8980 8980 SVC004566 PHOSPHOLIPID SYNDROME PANEL (CARDIOLIPIN ANTIBODIES IGG & IGM, PHOSPHOLIPID4500 6750 ANTIBODIES, LUPUS6750 ANTICOAGULANT)6750 6750 6750 SVC004567 CARDIAC PANEL - CARDIAC TROPONIN I, CREATINE PHOSPHOKINASE-MB (CPK-MB)780 780 780 780 780 780 SVC004569 K-RAS GENE STUDY 6670 10000 10000 10000 10000 10000 SVC004570 PARVOVIRUS B19 DNA PCR 2630 3940 3940 3940 3940 3940 SVC004571 GRBS BLOOD SUGAR EMERGENCY 40 60 60 60 60 60 SVC004572 NMDA RECEPTOR ANTIBODIES 6770 10160 10160 10160 10160 10160 SVC004573 BLOOD FOR 5 ALPHADIHYDRO TESTOSTERONE (DHT) 3200 4800 4800 4800 4800 4800 SVC004576 ACHR BLOCKING ANTIBODY 10400 15590 15590 15590 15590 15590 SVC004579 BLOOD FOR ALCOHOL LEVEL 740 1110 1110 1110 1110 1110 SVC004580 BLOOD FOR ALDEHYDE LEVEL 240 360 360 360 360 360 SVC004581 ANTI JO-1 ANTIBODY 1420 2130 2130 2130 2130 2130 SVC004582 ANTI SOLUBLE LIVER ANTIGEN 1370 2050 2050 2050 2050 2050 SVC004583 CULTURED AFB ANTIBIOTICS SENSITIVITY 10 DRUGS PANEL 11030 16540 16540 16540 16540 16540 SVC004586 ANTI SM IGG 1020 1530 1530 1530 1530 1530 SVC004587 ANTI THYROID ANTIBODIES - THYROGLOBLIN (TGAB) 1260 1890 1890 1890 1890 1890 SVC004588 BLOOD FOR TBPCR 2520 3780 3780 3780 3780 3780 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC004590 BRONCHIAL ASPIRATION FOR FUNGAL STAIN 250 380 380 380 380 380 SVC004593 BRONCHIAL FLUID FOR CYTOLOGY 700 1060 1060 1060 1060 1060 SVC004594 BRONCHIAL SECRETION FOR AFB CULTURE 1470 2210 2210 2210 2210 2210 SVC004595 BRONCHIAL SECRETION FOR FUNGAL STAIN 130 190 190 190 190 190 SVC004596 BRONCHIAL SECRETION FOR GRAM STAIN 130 190 190 190 190 190 SVC004597 BRONCHIAL SECRETION FOR Z-N STAIN 230 350 350 350 350 350 SVC004598 BRONCHIAL-SECRETION FOR FUNGAL CULTURE 370 550 550 550 550 550 SVC004599 SERUM FOR CA 72.4 (GASTRIC CANCER MARKER) 1520 2280 2280 2280 2280 2280 SVC004600 CAPD FLUID FOR FUNGAL STAIN 120 170 170 170 170 170 SVC004601 CAPD FLUID FOR GRAM STAIN 120 170 170 170 170 170 SVC004602 CAPD FLUID FOR CYTOLOGY 480 720 720 720 720 720 SVC004604 SERUM FOR CD 20 2210 3310 3310 3310 3310 3310 SVC004606 CERVICAL SMEAR FOR CYTOLOGY 890 1340 1340 1340 1340 1340 SVC004607 CHYLE TEST 250 380 380 380 380 380 SVC004610 CONJUNCTIVAL SWAB FOR GRAM STAIN 120 170 170 170 170 170 SVC004611 CONJUNCTIVAL SWAB FOR KOH 120 170 170 170 170 170 SVC004612 SERUM COPPER (ATOMIC ABSORPTION) 1630 2440 2440 2440 2440 2440 SVC004617 IHC FOR CYTOKERATIN 1630 2440 2440 2440 2440 2440 SVC004627 SERUM FOR ECHINO COCCAL 1630 2440 2440 2440 2440 2440 SVC004629 ESTROGEN RECEPTOR LEVEL 1370 2050 2050 2050 2050 2050 SVC004630 ESTROGEN LEVEL (TOTAL) 7300 10950 10950 10950 10950 10950 SVC004632 ENDOTRACHEAL TUBE (ET) SUCTION FOR FUNGAL CULTURE 1470 2210 2210 2210 2210 2210 SVC004643 SERUM FOR HCG (TOTAL) 690 1040 1040 1040 1040 1040 SVC004644 HEPATITIS B DNA 7670 11500 11500 11500 11500 11500 SVC004645 HEPATITIS C VIRAL RNA GENOTYPE (LIPA) 7040 10550 10550 10550 10550 10550 SVC004646 FISH FOR HER-2/NEU 16280 24410 24410 24410 24410 24410 SVC004649 HSV 2 IGG ANTIBODIES 740 1100 1100 1100 1100 1100 SVC004650 HSV 2 IGM ANTIBODIES 740 1100 1100 1100 1100 1100 SVC004651 RT-PCR FOR HIV-1 RNS QUANTITATIVE WITH CD-3, CD-4, CD-8 7700 11550 11550 11550 11550 11550 SVC004653 GENOTYPING FOR HCV (IL28B) 4830 7250 7250 7250 7250 7250 SVC004654 IMMUNO DEFICIENCY PANEL FOR CD-4 COUNT 1600 2400 2400 2400 2400 2400 SVC004655 CD 45 2210 3310 3310 3310 3310 3310 SVC004661 IHC FOR C-KIT 2000 2990 2990 2990 2990 2990 SVC004662 LEISHMANIA(KALA-AZAR) ANTIBODY (IGG) 1680 2520 2520 2520 2520 2520 SVC004663 LEPTOSPIRA ANTIBODY (IGG) (QUANTITATIVE) 1790 2680 2680 2680 2680 2680 SVC004664 LEPTOSPIRA ANTIBODY (IGG AND IGM) (QUANTITATIVE) 2500 3750 3750 3750 3750 3750 SVC004665 LEPTOSPIRA ANTIBODY (IGG AND IGM) (QUALITATIVE) 550 830 830 830 830 830 SVC004667 MATERNAL QUAD SCREEN TEST 4100 6140 6140 6140 6140 6140 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC004668 METABOLIC SCREENING (TMS) 600 900 900 900 900 900 SVC004671 NIPPLE DISCHARGE FOR CYTOLOGY 580 870 870 870 870 870 SVC004673 URINE FOR OPIATES (RANDOM) 680 1020 1020 1020 1020 1020 SVC004684 PROSTATIC SECRETION FOR CYTOLOGY 250 380 380 380 380 380 SVC004687 SERUM ASCITES ALBUMIN GRADIENT (SAAG) 340 510 510 510 510 510 SVC004689 SCL 70 ANTIBODY (IGG) 1050 1580 1580 1580 1580 1580 SVC004691 SERUM FOR FOLATE 1330 2000 2000 2000 2000 2000 SVC004695 SPUTUM FOR TBPCR 2310 3470 3470 3470 3470 3470 SVC004696 SPUTUM FOR CYTOLOGY 350 520 520 520 520 520 SVC004697 STOOL FOR PH 180 270 270 270 270 270 SVC004698 SYNOVIAL FLUID FOR FUNGAL STAIN 120 170 170 170 170 170 SVC004699 THERAPEUTIC PHLEBOTOMY 160 240 240 240 240 240 SVC004702 TSH RECEPTOR ANTIBODY (IGG) 6250 9370 9370 9370 9370 9370 SVC004703 TRANSFUSION TRANSMISSIBLE INFECTIONS (TTI) 1370 2050 2050 2050 2050 2050 SVC004704 TYPHOID ANTIBODY (IGG AND IGM) 620 930 930 930 930 930 SVC004705 URINE FOR CYTOLOGY 910 1370 1370 1370 1370 1370 SVC004707 URINE FOR ZN STAIN 120 170 170 170 170 170 SVC004709 RANDOM URINE FOR PROTEIN 260 390 390 390 390 390 SVC004712 WOUND SWAB FOR FUNGAL STAIN 120 170 170 170 170 170 SVC004716 SERUM FOR LIPOPROTEIN A 970 1460 1460 1460 1460 1460 SVC004718 URINE FOR SODIUM (24-HOURS) 280 420 420 420 420 420 SVC004719 IHC - 6 TO 10 MARKERS 8820 13230 13230 13230 13230 13230 SVC004720 IHC - 5 MARKERS 3780 5670 5670 5670 5670 5670 SVC004721 IHC - MORE THAN 10 MARKERS 10400 15590 15590 15590 15590 15590 SVC004724 ENTEROVIRUS ANTIBODIES PANEL (IGM & IGG) 1210 1810 1810 1810 1810 1810 SVC004726 SERUM VITAMIN E (TOCOPHEROL) 6300 9450 9450 9450 9450 9450 SVC004727 THIOPURINE METHYLTRANSFERASE (TPMT) 5200 7800 7800 7800 7800 7800 SVC004728 SERUM PARACETAMOL 1210 1810 1810 1810 1810 1810 SVC004729 BONE MARROW CYTOGENETICS KARYOTYPING 3360 5040 5040 5040 5040 5040 SVC004731 CHIMERISM (PRE BMT) 5990 8980 8980 8980 8980 8980 SVC004732 CHIMERISM (POST BMT) 5990 8980 8980 8980 8980 8980 SVC004733 CHIMERISM (BMT FOLLOW UP) 5990 8980 8980 8980 8980 8980 SVC004735 C -REACTIVE PROTEIN (CRP) -QUALITATIVE 190 290 290 290 290 290 SVC004737 QUADRUPLE TEST (MATERNAL SCREEN - AFP, BETA HCG, FREE ESTRIOL, INHIBIN3620 A) 5430 5430 5430 5430 5430 SVC004744 URINE FOR CHYLE 540 810 810 810 810 810 SVC004745 URINE FOR VMA (SPOT) 4040 6060 6060 6060 6060 6060 SVC004746 24 HOURS URINE PROTEIN/CREATININE RATIO 560 840 840 840 840 840 SVC004747 SS-A(RO) ANTIBODY 1450 2180 2180 2180 2180 2180 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC004748 SS-B(LA) ANTIBODY 1450 2180 2180 2180 2180 2180 SVC004751 URINE KETONE STRIPS 160 240 240 240 240 240 SVC004753 FREE THYROID PROFILE (FT3, FT4, TSH) 1080 1620 1620 1620 1620 1620 SVC004755 ADENOSINE DEAMINASE(ADA) - CSF 630 950 950 950 950 950 SVC004759 THROMBOELASTOGRAM (TEG) 4170 4170 4170 4170 4170 4170 SVC004766 URINE ROUTINE WITHOUT MICROSCOPY (INSTANT) 340 500 500 500 500 500 SVC004767 BRONCHIAL ASPIRATION FOR GRAM STAIN 130 190 190 190 190 190 SVC004768 BRONCHIAL ASPIRATION FOR Z-N STAIN 150 220 220 220 220 220 SVC004769 BRONCHIAL ASPIRATION FOR AFB CULTURE 2480 2480 2480 2480 2480 2480 SVC004770 MUSCLE SPECIFIC RECEPTOR TYROSINE KINASE AB(MUSK AB) 5780 8660 8660 8660 8660 8660 SVC004773 SLIDE & BLOCK FOR REVIEW (BONE MARROW) 910 1370 1370 1370 1370 1370 SVC004774 HIV (RAPID) 1130 1700 1700 1700 1700 1700 SVC004775 HBSAG (RAPID) 1130 1700 1700 1700 1700 1700 SVC004776 HCV (RAPID) 1230 1850 1850 1850 1850 1850 SVC004777 GENE XPERT (XPERTMTB/RIF) 2520 3780 3780 3780 3780 3780 SVC004778 AIR CULTURE 850 1280 1280 1280 1280 1280 SVC004779 WATER CULTURE (MPN METHOD) 1100 1650 1650 1650 1650 1650 SVC004782 ENDOTOXIN LEVEL 6880 10320 10320 10320 10320 10320 SVC004786 IHC FOR VIMENTIN (J032) 1630 2440 2440 2440 2440 2440 SVC004787 ALK MUTATION 10610 15910 15910 15910 15910 15910 SVC004790 SKIN FIBROBLAST CHROMOSOME ANALYSIS (CYTOGENETICS) 4360 6540 6540 6540 6540 6540 SVC004792 WHOLE BLOOD FOR SEROLIMUS (RAPAMYCIN) 4830 7250 7250 7250 7250 7250 SVC004793 ALDOSTERONE / PLASMA RENIN DIRECT RATIO 7040 10550 10550 10550 10550 10550 SVC004799 PARA NEOPLASTIC ANTIBODY PANEL WORKUP 6850 6850 6850 6850 6850 6850 SVC004801 IMMUNO DEFICIENCY PANEL II (CD3, CD4, DC8) 2510 3770 3770 3770 3770 3770 SVC004802 PRIMARY IMMUNODEFICIENCY PANEL(CD3, CD4, CD8, CD19, CD16, CD56, CD45)7880 11810 11810 11810 11810 11810 SVC004804 IMMUNO DEFICIENCY PANEL III (CD3) 2520 3780 3780 3780 3780 3780 SVC004806 LYMPHOMA DIAGNOSTIC PANEL (FLOW CYTOMETRY) 17120 25670 25670 25670 25670 25670 SVC004808 TRANSFERRIN SATURATION 1040 1560 1560 1560 1560 1560 SVC004810 HAND DRYER AIR CULTURE 750 1120 1120 1120 1120 1120 SVC004812 HAND IMPRESSION CULTURE 0 0 0 0 0 0 SVC004815 MONITOR SWAB 440 660 660 660 660 660 SVC004816 BED RAILING SWAB 440 660 660 660 660 660 SVC004818 DRESSING TROLLEY SWAB 440 660 660 660 660 660 SVC004822 ECG MACHINE SWAB 440 660 660 660 660 660 SVC004823 CARDIAC TABLE SWAB 440 660 660 660 660 660 SVC004827 MEDICINE TROLLEY SWAB 440 660 660 660 660 660 SVC004830 PATIENT TROLLEY SWAB 440 660 660 660 660 660 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC004831 DOOR HANDLE SWAB 440 660 660 660 660 660 SVC004832 WHOLE BLOOD CULTURE 700 1060 1060 1060 1060 1060 SVC004839 TRANSFUSION REACTION PATIENT CULTURE 700 1060 1060 1060 1060 1060 SVC004842 SINGLE BLOOD BAG STERILITY TEST 700 1060 1060 1060 1060 1060 SVC004843 DOUBLE BLOOD BAG (350ML) STERILITY TEST 700 1060 1060 1060 1060 1060 SVC004844 DOUBLE BLOOD BAG (450ML) STERILITY TEST 700 1060 1060 1060 1060 1060 SVC004845 TRIPLE BLOOD BAG STERILITY TEST 700 1060 1060 1060 1060 1060 SVC004847 ANAESTHESIA TROLLEY SWAB 440 660 660 660 660 660 SVC004849 FLOOR SWAB 440 660 660 660 660 660 SVC004850 INSTRUMENT TROLLEY SWAB 440 660 660 660 660 660 SVC004852 OT LAMP SWAB 440 660 660 660 660 660 SVC004853 OT TABLE SWAB 440 660 660 660 660 660 SVC004861 WALL SWAB 440 660 660 660 660 660 SVC004862 STERILE ROOM SWAB RACK 440 660 660 660 660 660 SVC004863 WBC COUNT 130 200 200 200 200 200 SVC004864 ALPHA THALASSEMIA MUTATION ANALYSIS BY DNA-PCR 2730 4100 4100 4100 4100 4100 SVC004871 ASPIRIN SENSITIVITY 1370 2050 2050 2050 2050 2050 SVC004872 MIXING STUDY (PT OR PTT) 3150 4730 4730 4730 4730 4730 SVC004873 TYPHIDOT 540 810 810 810 810 810 SVC004875 SERUM IGG 4 6500 9750 9750 9750 9750 9750 SVC004877 TISSUE FOR Z-N STAIN 500 760 760 760 760 760 SVC004878 DENGUE NS1 ANTIGEN (ELISA) 600 600 600 600 600 600 SVC004879 TISSUE FOR FUNGAL STAIN 160 240 240 240 240 240 SVC004882 TISSUE FOR GRAM STAIN 200 300 300 300 300 300 SVC004888 DRAIN FLUID FOR SODIUM 180 270 270 270 270 270 SVC004892 SES RNA VIRUS 11660 17480 17480 17480 17480 17480 SVC004893 CHROMOSOME MICRO ARRAY 44100 66150 66150 66150 66150 66150 SVC004896 HSV 1 & 2, IGG & IGM 2480 2480 2480 2480 2480 2480 SVC004897 ALLERGY EUROLINE (FOOD ALLERY PANEL) 3780 5670 5670 5670 5670 5670 SVC004899 MYELODYSPLASTIC SYNDROME FISH PANEL 8190 12290 12290 12290 12290 12290 SVC004903 ANA IMMUNOFLUOROSCENCE 2900 4350 4350 4350 4350 4350 SVC004904 ANTI HISTONES ANTIBODIES 1420 2130 2130 2130 2130 2130 SVC004908 GLUCOMETER RBS 130 200 200 200 200 200 SVC004912 MTHFR GENE MUTATION 2470 3700 3700 3700 3700 3700 SVC004913 PROTROMBIN GENE MUTATION 3470 5200 5200 5200 5200 5200 SVC004923 URINE FOR PROTEIN (SPOT) 120 180 180 180 180 180 SVC004926 SPOT URINE MICROALBUMIN / CREATININE RATIO 680 1020 1020 1020 1020 1020 SVC004927 CEREBROSPINAL FLUID (CSF) FOR CYTOLOGY 500 760 760 760 760 760 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC004929 PERICARDIAL FLUID FOR CELL COUNT 460 690 690 690 690 690 SVC004931 ASCITIC FLUID FOR CELL COUNT 490 740 740 740 740 740 SVC004932 CAPD FLUID FOR BIOCHEMISTRY 460 690 690 690 690 690 SVC004933 CAPD FLUID FOR CELL COUNT 460 690 690 690 690 690 SVC004935 DRAIN FLUID FOR CELL COUNT 470 710 710 710 710 710 SVC004936 DRAIN FLUID FOR CYTOLOGY 480 720 720 720 720 720 SVC004940 ASPIRATED FLUID FOR CELL COUNT 510 770 770 770 770 770 SVC004941 ASPIRATED FLUID FOR CYTOLOGY 500 760 760 760 760 760 SVC004944 FLUID FOR AMYLASE 470 710 710 710 710 710 SVC004945 FLUID FOR LIPASE 600 900 900 900 900 900 SVC004947 FLUID FOR LDH 520 780 780 780 780 780 SVC004948 FLUID FOR ALBUMIN 130 200 200 200 200 200 SVC004949 PLEURAL FLUID ROUTINE ANALYSIS (CELL COUNT AND BIOCHEMISTRY) 900 1350 1350 1350 1350 1350 SVC004950 VITAMIN B2 (RIBOFLAVIN) 8350 12520 12520 12520 12520 12520 SVC004951 MENINGOENCEPHALITIS PANEL,CSF 8350 12520 12520 12520 12520 12520 SVC004952 SCRUB TYPHUS,QUALITATIVE(CARD TEST) 840 1260 1260 1260 1260 1260 SVC004953 FUNGAL IDENTIFICATION & SENSITIVITY 800 1200 1200 1200 1200 1200 SVC004955 DIPHTHERIA IGG ANTIBODY 1680 2520 2520 2520 2520 2520 SVC004957 URINE EXAMINATION (ROUTINE) 120 170 170 170 170 170 SVC004962 TACROLIMUS (SAMPLE 5 AND ABOVE) 3100 4650 4650 4650 4650 4650 SVC004964 UREA, SERUM 160 240 240 240 240 240 SVC004965 PLEURAL FLUID FOR CYTOLOGY/MALIGNANT CELLS 570 850 850 850 850 850 SVC004966 CARDIOLIPIN ANTIBODIES PANEL (IGG, IGM & IGA) 2520 3780 3780 3780 3780 3780 SVC004967 URINE MPS QUANTITATIVE 3470 5200 5200 5200 5200 5200 SVC004968 URINE MPS ELECTROPHORESIS 1520 2280 2280 2280 2280 2280 SVC004969 TSH RECEPTOR ANTIBODY 4140 6210 6210 6210 6210 6210 SVC004976 SEPSIS 5570 8350 8350 8350 8350 8350 SVC004977 ACUTE ENCEPHALITIC SYNDROME 18900 28350 28350 28350 28350 28350 SVC004978 MENINGITIS 12080 18110 18110 18110 18110 18110 SVC004979 PDGFRA MUTATION ANALYSIS 4880 7320 7320 7320 7320 7320 SVC004980 AFB CULTURE & RADIOMETRIC SUSEPTIBILITY - 15 DRUG PANEL 12810 19220 19220 19220 19220 19220 SVC004982 AML COMBO QUEST V (COMBO PANEL OF NPM 1 EXON12&FLT3(ITD&D835) AND13450 CEBPA13450 MUTATION ANALYSIS.13450 ) 13450 13450 13450 SVC004985 METHOTREXATE 2700 4050 4050 4050 4050 4050 SVC004986 ANTI HEPATITIS DELTA VIRUS ANTIBODY IGM 2680 4020 4020 4020 4020 4020 SVC004987 PCR FOR JC/BK DNA 6830 10240 10240 10240 10240 10240 SVC004989 ENDOTOXIN FOR DIALYSIS RO WATER 1790 2680 2680 2680 2680 2680 SVC004995 CD 19 2150 3230 3230 3230 3230 3230 SVC004996 VENOUS BLOOD GAS-NON LAB 920 1380 1380 1380 1380 1380 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC004997 STOOL FOR CRYPTOSPORIDIUM/ISOSPORA IDENTIFICATION 330 500 500 500 500 500 SVC005000 COAGULATION PROFILE 2260 3390 3390 3390 3390 3390 SVC005004 ROTA VIRUS ANTIGEN DETECTION 1050 1050 1050 1050 1050 1050 SVC005007 HLA PANEL REACTIVE IGG ANTIBODIES (PRA) SCREEN 9570 9570 9570 9570 9570 9570 SVC005012 STRAND X - RARE DISEASES INHERITED PANEL TEST 22050 33080 33080 33080 33080 33080 SVC005015 24 HOURS URINE FOR UREA 320 480 480 480 480 480 SVC005017 ANTI DS DNA, IFA 3760 5640 5640 5640 5640 5640 SVC005018 POST SURGICAL HAND SCRUB SWAB FOR C/S 560 830 830 830 830 830 SVC005019 EYE SHOWER WATER FOR C/S 460 690 690 690 690 690 SVC005020 CSSD - STEAM 460 690 690 690 690 690 SVC005021 CSSD - ETO 460 690 690 690 690 690 SVC005022 CSSD - STEAM - CONTROL 460 690 690 690 690 690 SVC005023 CSSD - ETO - CONTROL 460 690 690 690 690 690 SVC005025 LAMINAR AIR FLOW SWAB FOR C/S 560 830 830 830 830 830 SVC005026 BBR FREEZE SWAB FOR C/S 560 830 830 830 830 830 SVC005027 DEEP FREEZE SWAB FOR C/S 460 690 690 690 690 690 SVC005028 PLATELETS AGGITATOR SWAB FOR C/S 460 690 690 690 690 690 SVC005031 PLASMA BATH SWAB FOR C/S 560 830 830 830 830 830 SVC005039 SWAB CULTURE PROFILE - RECOVERY ROOM 460 690 690 690 690 690 SVC005040 SWAB CULTURE PROFILE - PROCEDURE ROOM 560 830 830 830 830 830 SVC005042 INHIBIN B 2000 2990 2990 2990 2990 2990 SVC005043 PERITONEAL DAILYSIS FLUID ANALYSIS 720 1090 1090 1090 1090 1090 SVC005044 SERUM IMMUNOGLOBULIN D (IGD) 7300 10950 10950 10950 10950 10950 SVC005046 STERILITY CHECK 1050 1580 1580 1580 1580 1580 SVC005050 ASCITIC FLUID FOR GLUCOSE 90 140 140 140 140 140 SVC005052 BLOOD FOR CULTURE AUTOMATED 1260 1890 1890 1890 1890 1890 SVC005054 LIVER IRON ESTIMATION 5990 8980 8980 8980 8980 8980 SVC005055 CSF FOR TOTAL PROTEIN 170 250 250 250 250 250 SVC005056 TCR ALPHA BETA & CD19 DEPLETION 11660 17480 17480 17480 17480 17480 SVC005057 VITAMIN D 1,25 DIHYDROX 3360 5040 5040 5040 5040 5040 SVC005060 VIRAL PANEL FOR TRANSPLANT 8350 12520 12520 12520 12520 12520 SVC005065 TB PCR (GENEXPERT) 2540 3810 3810 3810 3810 3810 SVC005072 BRUCELLA ANTIBODIES IGM 1210 1810 1810 1810 1810 1810 SVC005074 LEUKEMIA/LYMPHOMA DIAGNOSTIC PANEL 28050 28050 28050 28050 28050 28050 SVC005075 ASTHMA /RHINITIS SCREENING PANEL 7430 7430 7430 7430 7430 7430 SVC005076 SCRUB TYPHUS IGM (ELISA) 930 1400 1400 1400 1400 1400 SVC005077 CREATINE KINASE-MB MASS 610 910 910 910 910 910 SVC005078 TRYPTASE 7040 10550 10550 10550 10550 10550 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC005079 PAPP-A 950 1420 1420 1420 1420 1420 SVC005080 DONAR SPECIFIC ANTIBODY (DSA) 5250 7880 7880 7880 7880 7880 SVC005082 ASPERGILLUS ANTIBODIES IGE 1160 1730 1730 1730 1730 1730 SVC005086 BK VIRUS QUANTITATIVE REAL TIME PCR 17430 26150 26150 26150 26150 26150 SVC005088 SES - SEPSIS WITH ANTIBIOTIC RESISTANCE 19640 29450 29450 29450 29450 29450 SVC005092 LYME DISEASE (BORRELIA BURGDORFERI IGG) 6200 9290 9290 9290 9290 9290 SVC005093 LYME DISEASE (BORRELIA BURGDORFERI IGM) 3570 5360 5360 5360 5360 5360 SVC005096 PERL'S/IRON STAINING- BONE MARROW 450 680 680 680 680 680 SVC005097 MYELOPEROXIDASE CYTOCHEMISTRY-BONE MARROW 530 790 790 790 790 790 SVC005099 HPV DNA HIGH RISK (CERVISTA) 1580 2360 2360 2360 2360 2360 SVC005111 EXTRACTABLE NUCLEAR ANTIGENS QUALITATIVE PROFILE (ENA) 4940 7400 7400 7400 7400 7400 SVC005114 JAK2 V617F MUTATION, QUALITATIVE PCR, LEUMETA WITH REFLEX TO EXONS12,1313700 13700 13700 13700 13700 13700 SVC005116 URINE OSMOLALITY (MEASURED) 430 650 650 650 650 650 SVC005117 SERUM OSMOLALITY (MEASURED) 420 630 630 630 630 630 SVC005118 ANTI HAV IGG 1390 2090 2090 2090 2090 2090 SVC005119 ANTI-U1 RNP ANTIBODIES 1790 2680 2680 2680 2680 2680 SVC005123 SINGLE 8 COLOR SCREENING PANEL (FLOW CYTOMETRIC IMMUNOPHENOTYPING)3200 4800 4800 4800 4800 4800 SVC005124 HEPATITIS E PCR QUALITATIVE 2680 4020 4020 4020 4020 4020 SVC005126 STRAND GERMLINE CANCER TEST - COMPREHENSIVE 16070 24100 24100 24100 24100 24100 SVC005129 STRAND CUSTOM GENE TEST 32030 48040 48040 48040 48040 48040 SVC005130 SINGLE MUTATION CONFIRMATION TEST 2420 3620 3620 3620 3620 3620 SVC005131 ANTI CARDIOLIPIN ANTIBODIES IGA 740 1100 1100 1100 1100 1100 SVC005133 BARBITURATES SCREENING - URINE 1160 1160 1160 1160 1160 1160 SVC005135 ENDOTOXIN TESTING(QUALITATIVE) 3620 5430 5430 5430 5430 5430 SVC005137 RICKETTSIA ANTIBODY PANEL (IGG, IGM, QUANTITATIVE BY IFA) 16800 25200 25200 25200 25200 25200 SVC005138 ANTI D TITRE 300 460 460 460 460 460 SVC005139 NMDA RECEPTOR ANTIBODY 10320 10320 10320 10320 10320 10320 SVC005140 CLL PANEL - FISH (P53/ATM AND D13S319/13QTER/12CEN/MYB6Q23) 9500 14250 14250 14250 14250 14250 SVC005141 FISH XX/XY IN OPPOSITE SEX BMT 6690 6690 6690 6690 6690 6690 SVC005142 BK VIRUS, PCR QUALITATIVE 4100 6140 6140 6140 6140 6140 SVC005149 CALPROTECTIN IN STOOL 3680 5520 5520 5520 5520 5520 SVC005151 HELICOBACTER PYLORI ANTIGEN IN STOOL 2210 3310 3310 3310 3310 3310 SVC005152 ADP TEST 1470 2210 2210 2210 2210 2210 SVC005153 SERUM TOTAL BILE ACID LEVEL 1730 2600 2600 2600 2600 2600 SVC005155 RAPID PLASMA REAGIN -SERUM(RPR) 330 490 490 490 490 490 SVC005156 RAPID PLASMA REAGIN -CSF(RPR) 260 390 390 390 390 390 SVC005158 LEUKEMIA PANEL (FLOW CYTOMETRY) 12500 18740 18740 18740 18740 18740 SVC005160 TTG (TISSUE TRANSGLUTAMINASE ) IGG 1050 1580 1580 1580 1580 1580 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC005161 HUMAN EPIDIDYMIS PROTEIN 4 (HE4)-SERUM 2210 3320 3320 3320 3320 3320 SVC005164 IGG SUBCLASS PANEL 6770 10160 10160 10160 10160 10160 SVC005165 TYPHI DOT IGM 560 840 840 840 840 840 SVC005167 BETA 2 GLYCOPROTEIN IGM 970 1450 1450 1450 1450 1450 SVC005168 BETA 2 GLYCOPROTEIN IGG 970 1450 1450 1450 1450 1450 SVC005171 CHROMOSOME ANALYSIS, HEMATOLOGIC MALIGNANCY, BLOOD/BONE MARROW3360 5040 5040 5040 5040 5040 SVC005173 CERVICAL SCREENING PANEL ( PAP SMEAR; HPV DETECTION &GENOTYPING) 1520 2280 2280 2280 2280 2280 SVC005179 URINE FOR AMYLASE 530 800 800 800 800 800 SVC005180 RED CELL DISTRIBUTION WIDTH (RDW) 80 130 130 130 130 130 SVC005183 PANCREATIC ELASTASE 5000 7500 7500 7500 7500 7500 SVC005185 FS+ 6720 10080 10080 10080 10080 10080 SVC005186 FS 6040 9060 9060 9060 9060 9060 SVC005193 GALACTOMANNAN 5630 8440 8440 8440 8440 8440 SVC005194 BRCA1 & BRCA 2 MUTATION 23100 23100 23100 23100 23100 23100 SVC005198 THROMBOPHILIA PROFILE 15000 22500 22500 22500 22500 22500 SVC005199 HAINS TEST 1800 2700 2700 2700 2700 2700 SVC005206 LEUKOVANTAGE, MYLEOID NEOPLASM MUTATION PANEL 25200 37800 37800 37800 37800 37800 SVC005207 ARSENIC, BLOOD 2890 4330 4330 4330 4330 4330 SVC005209 SINGLE ANTIGEN TEST 16380 24570 24570 24570 24570 24570 SVC005210 GANGLIOSIDE ANTIBODY PROFILE IGM 4410 6620 6620 6620 6620 6620 SVC005212 WHOLE EXOME SEQUENCING 54180 81270 81270 81270 81270 81270 SVC005216 NON MYCOBACTERIUM TUBERCULOSIS PCR 2840 4250 4250 4250 4250 4250 SVC005217 THROMBOPHILIA COMPREHENSIVE PROFILE 16500 24750 24750 24750 24750 24750 SVC005218 SERUM ETHANOL 750 1120 1120 1120 1120 1120 SVC005222 FACTOR X ASSAY 2150 3230 3230 3230 3230 3230 SVC005227 RESPIRATORY PCR PANEL I 6720 10080 10080 10080 10080 10080 SVC005228 SERUM PHYTANIC ACID 4990 7480 7480 7480 7480 7480 SVC005231 FLOWCYTOMETRIC PNH PANEL WITH FLAER 6620 9920 9920 9920 9920 9920 SVC005232 FLOWCYTOMETRIC CD 19/20 COUNT 2420 3620 3620 3620 3620 3620 SVC005233 FRUCTOSAMINE 490 740 740 740 740 740 SVC005234 BAL FLUID - CELL TYPE AND CELL COUNT 460 690 690 690 690 690 SVC005237 HIV - EARLY DETECTION PANEL 1 2840 4250 4250 4250 4250 4250 SVC005238 HIV - EARLY DETECTION PANEL 2 2360 3540 3540 3540 3540 3540 SVC005239 IMMUNOHISTOCHEMISTRY, INDIVIDUAL MARKER, S100 1630 2440 2440 2440 2440 2440 SVC005241 LEPTOSPIRA DETECTION, PCR 2630 3940 3940 3940 3940 3940 SVC005242 METHYL MALONIC ACID 1730 2600 2600 2600 2600 2600 SVC005245 BETA 2 GLYCOPROTEIN - 1, PANEL 2000 2990 2990 2990 2990 2990 SVC005247 BLOCKS CHARGES 280 430 430 430 430 430 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC005248 IMMUNOHISTOCHEMISTRY , CUSTOM PANEL 6930 10400 10400 10400 10400 10400 SVC005250 FISH FOR ONCOLOGY 1P AND 19Q CODELETION 9920 14880 14880 14880 14880 14880 SVC005259 HLA B27 (PCR METHOD) 3350 5030 5030 5030 5030 5030 SVC005264 AFB -MOTT ANTIBIOGRAAM PANEL FOR RAPID GROWERS UPTO 10 DRUGS 6410 9610 9610 9610 9610 9610 SVC005266 GENEXPERT+AFB CULTURE 3150 4730 4730 4730 4730 4730 SVC005268 BABY SHIELD 5 CONDITIONS- (HEEL PRICK) 1210 1810 1810 1810 1810 1810 SVC005269 PLASMA FREE METANEPHRINES 6000 6000 6000 6000 6000 6000 SVC005270 75 GM GTT ( GESTATIONAL) FASTING,1HR,2HR 260 390 390 390 390 390 SVC005271 100GM GTT ( GESTATIONAL) FASTING,1HR,2HR,3HR 390 580 580 580 580 580 SVC005272 75 GM GTT - FASTING,1HR,2HR,3HR 430 650 650 650 650 650 SVC005273 75 GM - EXTENDED GTT -FASTING,1HR,2HR,3HR,4HR 480 720 720 720 720 720 SVC005274 50 GM OGCT ( GESTATIONAL) 1 HR 160 240 240 240 240 240 SVC005275 75 GM GTT - FASTING,2HR 160 240 240 240 240 240 SVC005276 KI - 67 IHC 2000 2990 2990 2990 2990 2990 SVC005277 PLATELET SCREEN 190 280 280 280 280 280 SVC005279 PHOSPHOLIPID ANTIBODIES PANEL (IGG & IGM) 1540 2310 2310 2310 2310 2310 SVC005281 FISH - [ALL PANEL] BCR/ABL, TEL /AML1 & MLL 8090 12130 12130 12130 12130 12130 SVC005289 CHYLOMICRON 420 630 630 630 630 630 SVC005291 CMV DNA PCR 4100 6150 6150 6150 6150 6150 SVC005293 CHLAMYDIA TRACOMATIS AND NEISSERIA GONORRHOEAE, PCR QUALITATIVE 5040 7560 7560 7560 7560 7560 SVC005296 CYTOLOGY (PAP SMEAR), GENITAL, FEMALE, CONVENTIONAL 580 870 870 870 870 870 SVC005298 ANTI NMO (NEUROMYE LITIS OPTICA) 6500 6500 6500 6500 6500 6500 SVC005299 BETA 2 GLYCOPROTEIN 1 PANNEL IGG, IGM,IGA 2730 4100 4100 4100 4100 4100 SVC005302 T AND B CELL CROSS MATCH 3940 5910 5910 5910 5910 5910 SVC005305 FRAGILE X ALLELE SIZING BY TP PCR 6250 9370 9370 9370 9370 9370 SVC005307 CHIKUNGUNYA PCR 1050 1580 1580 1580 1580 1580 SVC005311 RT PCR QUALYTATIVE FOR PML RARA TRANSLOCATION 10320 10320 10320 10320 10320 10320 SVC005312 JAK2 REFLEX PANEL 6720 10080 10080 10080 10080 10080 SVC005313 HTLV 1 & 11 6270 6270 6270 6270 6270 6270 SVC005317 SERUM RPR 190 280 280 280 280 280 SVC005318 ECHINOCCOCUS (HYDATID CYST) DETECTION FLUID 500 750 750 750 750 750 SVC005323 CORTISOL FREE SERUM 7720 11580 11580 11580 11580 11580 SVC005324 EGFR, ALK AND ROS-1 MUTATION ANALYSIS 7000 10500 10500 10500 10500 10500 SVC005330 BODY FLUID FOR CYTOLOGY 580 870 870 870 870 870 SVC005338 EXTRACTABLENUCLEAR ANTIGENS (ENA), QUANTITATIVE PROFILE 7000 7000 7000 7000 7000 7000 SVC005339 SS-A/RO ANTIBODY 1680 2520 2520 2520 2520 2520 SVC005340 SS-B/LA ANTIBODY 1680 2520 2520 2520 2520 2520 SVC005343 IMMATURE PLATELET FRACTION (IPF) 630 950 950 950 950 950 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC005344 24 HOURS URINE FOR CHROMIUM 3360 5040 5040 5040 5040 5040 SVC005345 CHROMIUM (BLOOD TEST) 3360 5040 5040 5040 5040 5040 SVC005347 FANCONI'S ANEMIA, STRESS CYTOGENETICS 7770 11660 11660 11660 11660 11660 SVC005349 HEPATITIS B VIRUS (HBV)HBSAG -QUANTITATIVE SURFACE ANTIGEN 1550 2330 2330 2330 2330 2330 SVC005352 DPD GENE MUTATION 16800 25200 25200 25200 25200 25200 SVC005353 IHC PANEL (MICROSATELLITE INSTABILITY) 8090 12130 12130 12130 12130 12130 SVC005354 CLINICAL EXOME TEST 22050 33080 33080 33080 33080 33080 SVC005355 17-HYDROXY PROGESTERON 1450 2180 2180 2180 2180 2180 SVC005356 HLA T & B CELL LYMPHOCYTE CROSS MATCH 1840 2760 2760 2760 2760 2760 SVC005357 HLA - AB (CLASS 1) TYPING 7770 11660 11660 11660 11660 11660 SVC005358 HLA - DR (CLASS 2) TYPING 7770 11660 11660 11660 11660 11660 SVC005367 CHIMERISM SPLIT CELL ANALYSIS 7980 11970 11970 11970 11970 11970 SVC005370 PHADIATOP TEST 950 1430 1430 1430 1430 1430 SVC005372 MTB RAPID IDENTIFICATION 350 520 520 520 520 520 SVC005375 HLA TYPING 1ST 7460 11180 11180 11180 11180 11180 SVC005376 HLA TYPING 2ND 7460 11180 11180 11180 11180 11180 SVC005385 ENZYME ASSAY & GLUCOSIDASE (GAUCHER'S DISEASE) 3310 4960 4960 4960 4960 4960 SVC005388 CDC CROSS MATCHING 2890 4330 4330 4330 4330 4330 SVC005393 CARDIAC PANEL POC (SOB PANEL) [PROFILE] 2570 3860 3860 3860 3860 3860 SVC005396 HAEMOGLOBIN FOR FLUID 120 170 170 170 170 170 SVC005400 ER,PR & HER2 NEU 3580 5370 5370 5370 5370 5370 SVC005402 ADENOVIRUS QUANTIFICATION 4100 6140 6140 6140 6140 6140 SVC005406 CELL BLOCK STUDY 830 1250 1250 1250 1250 1250 SVC005407 MEASLES RUBEOLA PANNAL 4950 4950 4950 4950 4950 4950 SVC005409 URINE FOR DYSMORPHIC RBC 380 570 570 570 570 570 SVC005411 TNF, TUMOR NECROSIS FACTOR ALPHA 7430 7430 7430 7430 7430 7430 SVC005412 PHOSPHOLIPASE A2 RECEPTOR ANTIBODY (PLA2R) 6510 9770 9770 9770 9770 9770 SVC005414 HLA, PRA, IGG, CLASS I & II, QUANTITATIVE 11660 17480 17480 17480 17480 17480 SVC005423 MTFR (METHYLENE TETRAHYDROFOLATE REDUCTASE) GENEMUTATION QULITATIVE3360 PCR 5040 5040 5040 5040 5040 SVC005431 IHC MARKER 6040 9060 9060 9060 9060 9060 SVC005434 HLA DS (DONOR SPECIFIC IGG AB) 10500 15750 15750 15750 15750 15750 SVC005436 HIV 1 RNA QUANTITATIVE, REAL TIME PCR WITH CD3,CD4/CD8 MARKERS 7720 11580 11580 11580 11580 11580 SVC005437 AUTO IMMUNE ENCEPHALITIS PANEL 6720 10080 10080 10080 10080 10080 SVC005438 URINE FOR LEGIONELLA ANTIGEN 2400 3600 3600 3600 3600 3600 SVC005439 VITAMIN B12, ACTIVE; HOLOTRANSCOBALAMIN 1680 2520 2520 2520 2520 2520 SVC005441 ETHYL ALCOHOL-BLOOD LEVEL 630 950 950 950 950 950 SVC005442 IHC FOR DESMIN 1630 2440 2440 2440 2440 2440 SVC005443 AUTOIMMUNE ENCEPHATTIS PANEL 18900 28350 28350 28350 28350 28350 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC005448 HLA- ABDR MOLECULAR TYPING 10080 15120 15120 15120 15120 15120 SVC005452 TYPE & SCREEN (TS) 250 380 380 380 380 380 SVC005458 CMV QUANTITATIVE VIRAL LOAD PCR 8600 12900 12900 12900 12900 12900 SVC005469 POLARISING MICROSCOPY FOR CRYSTALS INCLUDES CELL COUNT SYNOVIAL FLUID320 470 470 470 470 470 SVC005481 HLA SINGLE ANTIGEN BEAD CLASS II 21000 31500 31500 31500 31500 31500 SVC005490 NOCARDIA, STAIN 390 590 590 590 590 590 SVC005531 SINGLE PROTOCOL (FLOW CYTOMETRY) 3150 4730 4730 4730 4730 4730 SVC005563 CANCER GENE ANY 3 MARKER (NGS) 13500 13500 13500 13500 13500 13500 SVC005585 IMMUNOGLOBULIN (IGG) SYNTHESIS INDEX & RATE 2450 2450 2450 2450 2450 2450 SVC005628 IHC -PDL-1 3500 4200 4200 4200 4200 4200 SVC005629 IHC -ALK-1 3500 4200 4200 4200 4200 4200 SVC005630 REGULAR HISTOPATHOLOGY -LARGE COMPLEX CANER RESECTION 3500 5250 5250 5250 5250 5250 SVC005636 DHEA DEHYDROEPIANDR OSTERONE 4050 4050 4050 4050 4050 4050 SVC005637 PARIETAL CELL ANTIBODY ,IFA IN DILUTION 3140 4710 4710 4710 4710 4710 SVC005650 LEISHMANIA(KALA-AZAR) ANTIBODY (RK39) 630 950 950 950 950 950 SVC005662 FISH-BCR/ABL OR PHILADELPHIA TRANSLOCATION 4520 6770 6770 6770 6770 6770 SVC005667 URINE LEGIONELLA ANTIGEN 10080 15120 15120 15120 15120 15120 SVC005671 COBALT-BLOOD 3360 5040 5040 5040 5040 5040 SVC005672 NT PRO BNP 3990 5990 5990 5990 5990 5990 SVC005681 HISTOPATHOLOGY,KIDNEY BIOPSY PANEL 2 1790 2680 2680 2680 2680 2680 SVC005682 HISTOPATHOLOGY,KIDNEY BIOPSY PANEL 3 9000 13500 13500 13500 13500 13500 SVC005683 ELECTRON MICROSCOPY(TEM) 7350 11030 11030 11030 11030 11030 SVC005684 ALLERGY FOOD PANEL2 8250 8250 8250 8250 8250 8250 SVC005685 GROWTH HORMONE SUPPRESSION BY GLUCOSE 2250 3380 3380 3380 3380 3380 SVC005855 DENGUE NS1 ANTIGEN-RAPID 600 600 600 600 600 600 SVC005858 MULTIPLE MYELOMA SCREENING PANEL 8400 12600 12600 12600 12600 12600 SVC005859 LEGIONELLA ANTIGEN,URINE(ICT) 720 1090 1090 1090 1090 1090 SVC005860 COCAINE & METABOLITE SCREEN,URINE 2520 3780 3780 3780 3780 3780 SVC005881 VGKC (VOLTAGE GATED POTASSIUM CHANNEL), ANTIBODY 7350 11030 11030 11030 11030 11030 SVC005882 NEURONAL(PARANEOPLASTIC)AUTOANTIBODIES PROFILE 9000 13500 13500 13500 13500 13500 SVC005883 BACTERIAL PNEUMONIA PANEL,PCR 7460 11180 11180 11180 11180 11180 SVC005884 HEPATITIS C VIRAL COMBO 8610 12920 12920 12920 12920 12920 SVC005905 TROPONIN-I HS ULTRA 1950 2930 2930 2930 2930 2930 SVC005909 HBSAG ELFA 700 1050 1050 1050 1050 1050 SVC005910 HIV ELFA 560 840 840 840 840 840 SVC005911 HCV ELFA 1680 2520 2520 2520 2520 2520 SVC005912 TISSUE TRANSGLUTAMINAS E TTGDGP SCREEN 2000 2990 2990 2990 2990 2990 SVC005913 HOMAIR INSULIN RESISTANCE INDEX,CPEPTIDE MODEL 2070 2070 2070 2070 2070 2070 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC005914 HERPES SIMPLEX VIRUS (HSV) 1 IGM,SERUM 740 1100 1100 1100 1100 1100 SVC005915 NEUROVIRUSES PANEL, QUALITATIVE PCR 6300 9450 9450 9450 9450 9450 SVC005916 HLA SINGLE ANTIGEN BEAD ASSAY FOR CLASS 1 & 2 IGG ANTIBODIES DSA SAB 42000CLASS 1 &63000 2 63000 63000 63000 63000 SVC005917 HLA T & B CELL FLOW CYTOMETRY, CROSSMATCH 3940 5910 5910 5910 5910 5910 SVC005918 THROMBOTIC RISK SCREEN 13650 20480 20480 20480 20480 20480 SVC005919 HIV - EIA 500 760 760 760 760 760 SVC005920 HCV (ANTI HCV ANTIBODY) - EIA 1520 2280 2280 2280 2280 2280 SVC005921 HBSAG (HEPATITS B SURFACE ANTIGEN) - EIA 530 790 790 790 790 790 SVC005922 FLUID IN BLOOD CULTURE BOTTLE 1340 2010 2010 2010 2010 2010 SVC005936 ELECTROLYTES (NA+,K+,CL+) 450 680 680 680 680 680 SVC005939 ROS-1 -IMMUNOHISTOCHEMISTRY 4200 6300 6300 6300 6300 6300 SVC005948 ABSOLUTE LEUKOCYTE COUNT 150 150 150 150 150 150 SVC006010 CSF PANEL- BIOFIRE METHOD 20000 20000 20000 20000 20000 20000 SVC006053 HLA DNA TYPING FOR KIDNEY / LIVER TRANSPLANT, PCR 14800 22200 22200 22200 22200 22200 SVC006064 BRAF MUTATION ANALYSIS (IHC) 5700 5700 5700 5700 5700 5700 SVC006065 KRAS NRAS MUTATION ANALYSIS (IHC) 11000 11000 11000 11000 11000 11000 SVC006091 ANTI B TITRE,IGG 1000 1000 1000 1000 1000 1000 SVC006092 BRAF MUTATION ANALYSIS (PCR) 5700 5700 5700 5700 5700 5700 SVC006117 GENE EXPERT CARBA 8000 8000 8000 8000 8000 8000 SVC011232 COMPLETE BLOOD COUNT (CBC) 450 680 680 680 680 680 SVC011233 DIALYSIS VIROLOGY PROFILE (HIV, HCV AND HBS AG ) - RAPID 1550 2330 2330 2330 2330 2330 SVC011234 LIVER FUNCTION TEST(LFT) 1000 1500 1500 1500 1500 1500 SVC011235 LIPID PROFILE (CHOL,TRIG,HDL,LDL,VLDL) 1100 1650 1650 1650 1650 1650 SVC011236 TORCH IGM ANTIBODIES 1960 2940 2940 2940 2940 2940 SVC011237 SEROLOGY PROFILE 2030 3040 3040 3040 3040 3040 SVC011238 IRON PROFILE 530 790 790 790 790 790 SVC011240 RENAL PACKAGE - 1 610 910 910 910 910 910 SVC011243 DIALYSIS PACKAGE - 2 900 1350 1350 1350 1350 1350 SVC011247 THROMBOPHILIA WORK UP 14070 21110 21110 21110 21110 21110 SVC011248 TORCH IGG ANTIBODIES 3100 4650 4650 4650 4650 4650 SVC011249 HEPATITIS B PROFILE 4410 6620 6620 6620 6620 6620 SVC011250 COMPLETE HAEMOGRAM (CGHS) 140 210 210 210 210 210 SVC011251 SWAB CULTURE PROFILE - NH OT 700 1060 1060 1060 1060 1060 SVC011252 SWAB CULTURE PROFILE - NURSING STATION 670 1010 1010 1010 1010 1010 SVC011260 ARTHRITIS PROFILE 1 2420 3620 3620 3620 3620 3620 SVC011261 ARTHRITIS PROFILE 2 : (WITHOUT ANTI CCP) 3260 4880 4880 4880 4880 4880 SVC011269 ASCITIC FLUID ROUTINE ANALYSIS (CELL COUNT AND BIOCHEMISTRY) 820 1230 1230 1230 1230 1230 SVC011271 NEWBORN SCREENING- BASIC 1890 2840 2840 2840 2840 2840 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC011272 NEWBORN SCREENING-EXTENDED PROFILE 5250 7880 7880 7880 7880 7880 SVC011286 RHEUMATOID ARTHRITIS PANEL 1680 2520 2520 2520 2520 2520 SVC011287 FIBROMYALGIA PANEL 5880 8820 8820 8820 8820 8820 SVC011303 IRON PROFILE: SERUM IRON, TIBC, TRANSFERRIN SATURATION 610 960 960 960 960 960 SVC011305 KIDNEY FUNCTION TEST PROFILE 1000 1500 1500 1500 1500 1500 SVC011306 DIALYSIS SEROLOGY PROFILE(CHEMILUMINESCENCE / ELFA ) 2370 3560 3560 3560 3560 3560 SVC011307 COMPLETE BLOOD COUNT WITH ALC 370 550 550 550 550 550 SVC011331 PRE OPERATIVE (PAEDIATRIC)(CTVS) PROFILE 5460 8190 8190 8190 8190 8190 SVC011333 PRE OPERATIVE (VALVE) PROFILE 5510 8270 8270 8270 8270 8270 SVC011334 PRE OPERATIVE (CABG) PROFILE 5900 8850 8850 8850 8850 8850 SVC011340 CATH STUDY/DEVICE CLOSURE/EPS/RFA/BMV2 3680 5510 5510 5510 5510 5510 SVC011341 CAG/PTCA PROFILE 3580 5370 5370 5370 5370 5370 SVC011342 PRE OP PROFILE-2 6100 9150 9150 9150 9150 9150 SVC011343 PRE OP PROFILE-1 5100 7650 7650 7650 7650 7650 SVC011344 DIALYSIS PROFILE-2 4460 6690 6690 6690 6690 6690 SVC011345 DIALYSIS PROFILE-1 1840 2760 2760 2760 2760 2760 SVC011346 KIDNEY FUNCTION EXTENDED PROFILE 1400 2100 2100 2100 2100 2100 SVC011370 COMPLETE HAEMOGRAM 510 765 765 765 765 765 SVC011381 RENAL PACKAGE - 2 1100 1650 1650 1650 1650 1650 SVC011450 FOUNDATION ONE/NGS 260000 260000 260000 260000 260000 260000 SVC011453 IMMUNOHISTOCHEMISTRY CMV 1850 1850 1850 1850 1850 1850 SVC011470 GIARDIA LAMBILA ANTIGEN DETECTION 670 690 690 690 690 690 SVC011852 CORTISOL STIMULATION BY ACTH 1730 2600 2600 2600 2600 2600 SVC011853 Anti MOG (Myelin Oligodendrocyte Glycoprotein) 6500 6500 6500 6500 6500 6500 SVC011861 OSMOLAL GAP, SERUM 980 980 980 980 980 980 SVC011869 MEAN PLATELET VOLUME 0 0 0 0 0 0 SVC011876 KRAS NRAS MUTATION ANALYSIS (PCR) 11000 11000 11000 11000 11000 11000 SVC011877 HPV, CHLAMYDIA TRACHOMATIS & NEISSERIA GONORRHEA PCR PANEL, QUALITATIVE4800 4800 4800 4800 4800 4800 SVC011878 LEGIONELLA PNEUMOPHILA TOTAL ANTIBODY, SERUM 6980 6980 6980 6980 6980 6980 SVC011879 LUPUS ANTICOAGULANT PANEL; LAC PANEL. 2730 2730 2730 2730 2730 2730 SVC011885 BIOFIRE ME(MENINGOENCEPHALITIS) ADVANTAGE 20800 20800 20800 20800 20800 20800 SVC012365 COVID 19 VIRUS QUALITATIVE PCR 1250 1250 1250 1250 1250 1250 SVC012638 IGG COVID Antibody 250 250 250 250 250 250 SVC012678 Standard QÂ COVID-19 Ag 650 650 650 650 650 650 SVC012679 SYSTEMIC LUPUS ERYTHEMATOSUS PANEL 4360 6540 6540 6540 6540 6540 SVC012900 METAL SCREEN 1Â SERUM 6330 6330 6330 6330 6330 6330 SVC012901 METAL SCREEN 3, URINE 15400 15400 15400 15400 15400 15400 SVC012902 NOTCH3 MUTATION DETECTION; CADASIL 11000 11000 11000 11000 11000 11000 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC012963 BRCA1 & BRCA2 MUTATION DRUG PROFILING PANEL 25000 25000 25000 25000 25000 25000 SVC013142 ANTEGRADE PYELOGRAPHY 10000 10000 13000 15000 17000 19000 Liver Transplant PKG004519 LIVER TRANSPLANT (RECIPIENT) - C PKG 2500000 2500000 2500000 2800000 2800000 PKG004527 LIVER TRANSPLANT (DONOR) PKG 0 0 0 0 0 SVC003189 LIVER TRANSPLANT RECIPIENT - LIFETIME FOLLOW-UP FEES 100000 100000 100000 100000 100000 100000 SVC007764 BONE MARROW ASPIRATION - PEDIATRIC 3850 5010 5780 6550 7320 SVC007765 ANOPLASTY 19580 25450 29370 33290 37200 SVC007767 BILATERAL INGUINAL HERNIOTOMIES 19910 25880 29870 33850 37830 SVC007768 BLADDER AUGMENTATION 62590 81370 93890 106400 118920 SVC007772 CIRCUMCISION - PEDIATRIC 7210 9370 10810 12250 13690 SVC007777 DISTAL PANCREATECTOMY - PEDIATRIC SURGERY 38500 50050 57750 65450 73150 SVC007778 DRAINAGE OF PSEUDO PANCREATIC CYST 25850 33610 38780 43950 49120 SVC007779 ENCEPHALOCELE -EXCISION & REPAIR 38500 50050 57750 65450 73150 SVC007789 FASCIOTOMY 15620 20310 23430 26550 29680 SVC007790 FEEDING GASTROSTOMY 13200 17160 19800 22440 25080 SVC007793 GASTROSTOMY 23540 30600 35310 40020 44730 SVC007794 HEMITHYROIDECTOMY 21890 28460 32840 37210 41590 SVC007795 HERNIOTOMIES (UMBILICAL / INGUINAL) 14080 18300 21120 23940 26750 SVC007799 INTUSSUSCEPTION REDUCTION (PNEUMATIC) 28820 37470 43230 48990 54760 SVC007802 LAPAROSCOPIC ORCHIDOPEXY 30800 40040 46200 52360 58520 SVC007812 MECKELS DIVERTICULECTOMY 17270 22450 25910 29360 32810 SVC007814 NEPHRECTOMY 30030 39040 45050 51050 57060 SVC007816 OPERATIVE CHOLANGIOGRAM / OPEN LIVER BIOPSY 5500 7150 8250 9350 10450 SVC007817 PAROTIDECTOMY - SUPERFICIAL 21890 28460 32840 37210 41590 SVC007818 PAROTIDECTOMY -TOTAL 27390 35610 41090 46560 52040 SVC007824 RECTAL POLYPECTOMY 8800 11440 13200 14960 16720 SVC007825 RECTAL PROLAPSE (SCLEROTHERAPY / THIERSCH WIRE) 22000 28600 33000 37400 41800 SVC007826 RECTOPEXY 31240 40610 46860 53110 59360 SVC007830 SPLENORRHAPHY 24200 31460 36300 41140 45980 SVC007831 STERNOMASTOID RELEASE 9300 12080 13940 15800 17660 SVC007836 SURGICAL CORRECTION OF CONGENITAL HYPERTOPHIC PYLORIC STENOSIS 21560 28030 32340 36650 40960 SVC007844 THORACOTOMY 31240 40610 46860 53110 59360 SVC007845 TONGUE TIE RELEASE 4400 5720 6600 7480 8360 SVC007846 TOTAL THYROIDECTOMY 27500 35750 41250 46750 52250 SVC007859 LAPAROSCOPIC NEPHROURETERECTOMY (UNILATERAL) 54120 70360 81180 92000 102830 SVC007864 LAPAROSCOPIC COLOSTOMY 17050 22170 25580 28990 32400 SVC007865 UNILATERAL ORCHIDOPEXY 18810 24450 28220 31980 35740 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC007866 SUTURING OF LACERATION 5940 7720 8910 10100 11290 SVC007871 MUSCLE BIOPSY 3630 4720 5450 6170 6900 SVC007875 HELLER'S CARDIOMYOTOMY(OPEN) 27500 35750 41250 46750 52250 SVC007897 MESENTRIC CYST EXCISION 21120 27460 31680 35900 40130 SVC007898 ANAL DILATATION 5060 6580 7590 8600 9610 SVC007905 GENITOSCOPY 630 820 940 1070 1190 SVC007908 LAPAROTOMY + ADHESIOLYSIS 19690 25600 29540 33470 37410 SVC007909 URETHROCUTANEOUS FISTULA CLOSURE 24200 31460 36300 41140 45980 SVC007913 RADICAL NEPHRO-URETERECTOMY 43230 56200 64850 73490 82140 SVC007920 ANAL TRANSPOSITION SURGERY 22440 29170 33660 38150 42640 SVC007922 BRONCHOSCOPY - FOREIGN BODY REMOVAL 11880 15440 17820 20200 22570 SVC007925 COLOSTOMY 22440 29170 33660 38150 42640 SVC007928 DIAGNOSTIC BRONCHOSCOPY 9410 12230 14110 15990 17870 SVC007929 DIAGNOSTIC CYSTOSCOPY / PANENDOSCOPY 7700 10010 11550 13090 14630 SVC007930 ENCEPHALOCELE SURGERY 38500 50050 57750 65450 73150 SVC007934 GASTROSTOMY / JEJUNOSTOMY LAPROSCOPIC 20240 26310 30360 34410 38460 SVC007937 HYDROCELE UNILATERAL LAPROSCOPIC 12540 16300 18810 21320 23830 SVC007938 ILEOSTOMY 16280 21160 24420 27680 30930 SVC007949 OPEN RECURRENT INGUINAL HERNIA 17160 22310 25740 29170 32600 SVC007951 SUPRAPUBIC CYSTOSTOMY 9350 12160 14030 15900 17770 SVC007963 LIMITED POSTERIOR SAGITTAL ANORECTOPLASTY(PSARP) 26180 34030 39270 44510 49740 SVC007971 CYST EXCISION 7700 10010 11550 13090 14630 Medical Oncology SVC006779 CHEMO PORT REMOVAL- GA 3580 4650 5360 6080 6790 SVC006784 LUMBAR TRANSFORAMINAL EPIDURAL INJECTION 15050 19560 22570 25580 28590 SVC006789 CAUDAL EPIDURAL STEROID INJECTION 8250 10730 12380 14030 15680 SVC006803 TRIGEMINAL GANGLION INJECTION (DIAGNOSTIC) 22000 28600 33000 37400 41800 SVC006810 CHEMOTHERAPHY PROTOCOL CHARGES-A 10500 10500 10500 10500 10500 SVC006812 CHEMOTHERAPY PLANNING CHARGES 6300 8190 9450 10710 11970 SVC006813 ULTRASOUND GUIDED CENTRAL LINE INSERTION 7260 9440 10890 12340 13790 SVC006820 CHEMOTHERAPY CHARGES - BIOLOGICALS 7350 9560 11030 12500 13970 SVC006827 IV PUSH/IM CHEMO/HORMONAL AGENT ADMINISTRATION ONLY 1380 1790 2060 2340 2610 SVC006828 ZOLEDRONIC ACID ADMINISTRATION 1650 2150 2480 2810 3140 SVC006829 INTRATHECAL CHEMOTHERAPY 5500 7150 8250 9350 10450 SVC006832 MULTIPLE DRUGS 7700 10010 11550 13090 14630 SVC006833 SINGLE DRUGS 3300 4290 4950 5610 6270 SVC006834 CHEMO TRANSFUSION & MONITORING CHARGES (PER DAY) 2960 3850 4440 5030 5620 SVC006835 CHEMOPORT CARE & FLUSHING 790 1030 1190 1340 1500 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC006836 PICC LINE CATHETER CARE & FLUSHING 790 1030 1190 1340 1500 SVC006846 INTRA OMMAYA RESERVOIR 11000 14300 16500 18700 20900 SVC006848 CVP INSERTION / PICC INSERTION 4400 5720 6600 7480 8360 SVC006859 BONE MARROW BIOPSY 4400 5720 6600 7480 8360 SVC006860 BONE MARROW ASPIRATION & BIOPSY 7260 9440 10890 12340 13790 SVC006861 CHEMOTHERAPY CONTINUOUS INFUSION 9900 12870 14850 16830 18810 SVC006862 INTRATHECAL-DIAGNOSTICS 3850 5010 5780 6550 7320 SVC006868 SEROMA ASPIRATION. 2200 2200 2200 2200 2200 SVC011928 CHEMO PLANNING AND PROTOCOL CHARGES_ 15400 20020 23100 26180 29260 Nephrology PKG004141 RENAL TRANSPLANT (DONOR) - RELATED PKG 180000 180000 180000 234000 270000 PKG004158 RENAL TRANSPLANT (RECIPIENT) - RELATED PKG 270000 270000 270000 351000 405000 PKG016177 HAEMODIALYSIS PKG 2090 2720 3140 3550 3970 PKG016180 DIALYSIS SINGLE USE PKG 2600 3380 3900 4420 4940 PKG016181 DIALYSIS HI FLEX PKG 3500 4550 5250 5950 6650 PKG016182 DIALYSIS RE-USE PKG 2000 2600 3000 3400 3800 PKG016183 DIALYSIS SLED PKG 3920 5090 5870 6660 7440 PKG016184 DIALYSIS HDF PKG 3800 4940 5700 6460 7220 PKG016185 Pre-workup Kidney Transplant Recipient 66000 85800 99000 112200 125400 PKG016186 Pre-workup Kidney Transplant Donor 44000 57200 66000 74800 83600 SVC006268 KIDNEY BIOPSY ( USING NEW GUN ) 7920 10300 11880 13460 15050 SVC006271 PERITONEAL DIALYSIS 3910 5080 5860 6640 7420 SVC006274 PLASMAPHARESIS 16410 21340 24620 27900 31180 SVC006275 HAEMODIALYSIS 2700 3510 4050 4590 5130 SVC006276 DIALYSIS SHEATH INSERTION 3080 4000 4620 5240 5850 SVC006278 RENAL TRANSPLANT (RECIPIENT) 270000 270000 270000 351000 405000 SVC006280 FEMORAL CATHETERIZATION 2630 3420 3950 4470 5000 SVC006283 HAEMODIALYSIS (WITH NEW DIALYZER) 4200 5460 6300 7140 7980 SVC006286 DIALYSIS (SINGLE USE ) 2300 2300 2300 2300 2300 SVC006304 JUGULAR DOUBLE LUMEN CATHETERIZATION 3030 3930 4540 5140 5750 SVC006305 SUSTAINED LOW EFFICIENCY DIALYSIS (SLED) 6 HOURS 4140 5380 6200 7030 7860 SVC006306 FRESENIUS 5008 HEMODIAFILTRATION 4800 6240 7200 8160 9120 SVC006307 FRESENIUS 5008 HEMODIAFILTRATION-RE USE 3270 4250 4900 5550 6210 SVC011625 CONTINUOUS RENAL REPLACEMENT THERAPY (CRRT) PER DAY 12270 15940 18400 20850 23300 SVC011626 CONTINUOUS RENAL REPLACEMENT THERAPY (CRRT) FOR 12 HRS 6770 8790 10150 11500 12850 Neurology SVC003438 PARENT VESSEL OCCLUSION 34650 45050 51980 58910 65840 SVC006291 CONTINOUS RENAL REPLACEMENT THERAPY (CRRT) INITIATION CHARGES 12100 12100 12100 12100 12100 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC006316 BAER 2370 2370 3070 3550 4020 4490 SVC006317 EEG 2920 4380 5690 6570 7450 8320 SVC006318 LUMBAR PUNCTURE WITH CSF MONITORING 1650 2150 2480 2810 3140 SVC006319 NCV - FOUR LIMBS 5400 8100 10530 12150 13770 15390 SVC006320 NCV - TWO LIMBS 4100 6150 8000 9230 10460 11690 SVC006321 NCV FACIAL 1740 1740 2260 2610 2960 3310 SVC006327 RNS (REPETITIVE NERVE STIMULATION) 1890 2840 3690 4250 4820 5390 SVC006369 VISUALLY EVOKED POTENTIAL (VEP) 3200 3200 4160 4800 5440 6080 SVC006370 VEEG-I 3030 3030 3930 4540 5140 5750 SVC006371 EEG - R 1600 1600 2070 2390 2710 3030 SVC006376 NEOSTIGMINE TEST 5080 5080 6610 7620 8640 9660 SVC006377 SSEP 2370 2370 3070 3550 4020 4490 SVC006378 VEEG - II 5390 5390 7010 8090 9160 10240 SVC006379 VEEG - III 6330 6330 8220 9490 10750 12020 SVC006380 VEEG - IV 11110 11110 14440 16670 18890 21110 SVC006382 NERVE BIOPSY 3740 4860 5610 6360 7110 SVC006384 NEEDLE EMG - 3-4 MUSCLES 1710 1710 2220 2560 2900 3240 SVC006390 DIGITAL SUBSTRACTION ANGIOGRAM (DSA OR CEREBRAL ANGIOGRAM) 12100 15730 18150 20570 22990 SVC006391 BOTOX INJECTION TYPE 2 4840 4840 6290 7260 8230 9200 SVC006392 BOTOX INJECTION TYPE 1 2480 2480 3220 3710 4210 4700 SVC006394 NCV SINGLE NERVE 1580 1580 2050 2370 2690 3000 SVC006407 SKULL TRACTION 10010 13010 15020 17020 19020 SVC006416 BURR HOLE AND ASPIRATION OF ABSCESS (SINGLE) 7870 10220 11800 13370 14940 SVC006427 DERMOID 3520 4580 5280 5980 6690 SVC006429 USE OF SKULL BASE APPROACH FOR TUMOR RESECTION 71500 92950 107250 121550 135850 SVC006430 CP ANGLE TUMOR 99330 129130 149000 168860 188730 SVC006434 EMG WITH NCV B/L UL 4050 5270 6080 6890 7700 SVC006435 EMG WITH NCV B/L LL 4050 5270 6080 6890 7700 SVC006440 EEG 2HR 3300 3300 4290 4950 5610 6270 SVC006441 EEG 4HR 4400 4400 5720 6600 7480 8360 SVC006443 EEG 12HR 11000 11000 14300 16500 18700 20900 SVC006444 EEG 24HR 16500 16500 21450 24750 28050 31350 SVC006445 EEG 48 HR 22000 22000 28600 33000 37400 41800 SVC006447 NCV WITH EMG- BRACHIAL PLEXIS 4730 6150 7100 8040 8990 SVC006448 NCV WITH EMG- LUMBAR PLEXIS 4950 6440 7430 8420 9410 SVC006449 EMG WITH NCV-ALL FOUR LIMBS 5250 6830 7880 8930 9980 Neurosurgery SVC006462 BRACHIAL PLEXUS TUMOR EXCISION 55000 71500 82500 93500 104500 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC006463 BRAIN ABSCESS TAPPING 3300 4290 4950 5610 6270 SVC006464 CAROTID ENDARTECTOMY 55000 71500 82500 93500 104500 SVC006465 CARPAL TUNNEL RELEASE 20460 26600 30690 34780 38870 SVC006466 CERVICAL CORPECTOMY WITH FUSION 49500 64350 74250 84150 94050 SVC006468 CHRONIC SUBDURAL HEMATOMA COMPLEX / BILATERAL 49500 64350 74250 84150 94050 SVC006471 CRANIOPLASTY 55000 71500 82500 93500 104500 SVC006472 CRANIOSYNOSTOSIS 55000 71500 82500 93500 104500 SVC006475 ENDOSCOPIC REPAIR OF CSF RHINORRHEA 49500 64350 74250 84150 94050 SVC006476 ENDOSCOPIC THIRD VENTRICULOSTOMY 55000 71500 82500 93500 104500 SVC006478 EPILEPSY SURGERY MTS 49500 64350 74250 84150 94050 SVC006481 FORAMEN MAGNUM DECOMPRESSION 44000 57200 66000 74800 83600 SVC006482 ICP MONITORING 2810 3650 4210 4770 5330 SVC006484 INTRATHECAL BACLOFEN PUMP IMPLANTATION 27500 35750 41250 46750 52250 SVC006488 PERIPHERAL NERVE SURGERY 38500 50050 57750 65450 73150 SVC006490 RESECTION OF SPINAL EXTRAMEDULLARY SIMPLE TUMOR 55000 71500 82500 93500 104500 SVC006491 SPINAL INTRA MEDULLARY TUMORS 68200 88660 102300 115940 129580 SVC006492 SPINE BIFIDA MINOR (FILUM ONLY) 16500 21450 24750 28050 31350 SVC006493 STEREOTACTIC BIOPSY 55000 71500 82500 93500 104500 SVC006496 SURGICAL MANAGEMENT OF SPINAL DYSRAPHISM 55000 71500 82500 93500 104500 SVC006497 SURGICAL TREATMENT OF MENINGOENCEPHALOCELE 49500 64350 74250 84150 94050 SVC006503 CRANIOTOMY FOR CLIPPING OF ANEURYSM / AVAL / AVM 70400 91520 105600 119680 133760 SVC006506 SKULL BASE TUMOR EXCISION ENDOSCOPIC 71500 92950 107250 121550 135850 SVC006517 ELEVATION OF DEPRESSED FRACTURE AND DURAPLASTY 49500 64350 74250 84150 94050 SVC006519 LUMBOPERITONEAL SHUNT 22000 28600 33000 37400 41800 SVC006521 NERVE TRANSPOSITION 14300 18590 21450 24310 27170 SVC006528 EVD (EXTERNAL VENTRICULAR DRAIN) INSERTION 16500 21450 24750 28050 31350 SVC006531 LUMBAR DRAIN 6110 7940 9160 10380 11600 SVC006532 TRACHEOSTOMY CHANGE 730 950 1100 1240 1390 SVC006538 SPINAL EXTRAMEDULLARY COMPLEX TUMORS 55000 71500 82500 93500 104500 SVC006541 BRACHIAL PLEXUS REPAIR (PERIPHERAL NERVE LEVEL) 49500 64350 74250 84150 94050 SVC006542 BRACHIAL PLEXUS REPAIR (ROOT LEVEL) 60500 78650 90750 102850 114950 SVC006544 PERIPHERAL NERVE SURGERY (NERVE REPAIR WITH NERVE GRAFT) 44880 58340 67320 76300 85270 SVC006546 VENTRICULOATRIAL SHUNT 52800 68640 79200 89760 100320 SVC006550 SPINAL EXTRADURAL TUMOR 83050 107970 124580 141190 157800 SVC006555 CERVICAL DISCECTOMY (MULTIPLE LEVELS) 55000 71500 82500 93500 104500 SVC006556 BRACHIAL PLEXUS TUMOR EXCISION (ROOT LEVEL) 60500 78650 90750 102850 114950 SVC006557 CERVICAL CORPECTOMY WITH FUSION (TWO LEVELS) 60500 78650 90750 102850 114950 SVC006558 CHRONIC SUBDURAL HEMATOMA (UNILATERAL) 38500 50050 57750 65450 73150 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC006559 ENDOSCOPIC PITUITARY SURGERY 56100 72930 84150 95370 106590 SVC006563 LAMINECTOMY (C1-C2) 44220 57490 66330 75170 84020 SVC006564 SPINAL FUSION 53680 69780 80520 91260 101990 SVC006566 BONE FLAP REMOVAL 13200 17160 19800 22440 25080 SVC006567 VENTRICULO PERITONIAL / VENTRCULO ATRIAL SHUNT 33000 42900 49500 56100 62700 SVC006574 DECOMPRESSIVE CRANIOTOMY WITH DUROPLASTY 44000 57200 66000 74800 83600 SVC006576 LAMINECTOMY TUMOR MULTIPLE LEVEL LARGE 51810 67350 77720 88080 98440 SVC006585 IMPLANT REMOVAL 6710 8720 10070 11410 12750 SVC006591 DEEP BRAIN STIMULATION 82500 107250 123750 140250 156750 SVC006592 C.V. JUNCTION FUSION 68200 88660 102300 115940 129580 SVC006595 DORSAL SPINAL DECOMPRESSION 69300 90090 103950 117810 131670 SVC006596 DORSAL SPINAL TUMOR EXCISION 83050 107970 124580 141190 157800 SVC006598 LUMBAR SPINAL DECOMPRESSION AND FIXATION 45940 59720 68900 78090 87280 SVC006599 LUMBAR SPINAL LAMINECTOMY 49500 64350 74250 84150 94050 SVC006600 SCALP TUMOR EXCISION - MINOR 11000 14300 16500 18700 20900 SVC006602 CRANIOTOMY AND EVACUATION OF HAEMATOMA 55000 71500 82500 93500 104500 SVC006607 CSF FISTULA REPAIR 16500 21450 24750 28050 31350 SVC006608 SCALP REPAIR 7700 10010 11550 13090 14630 SVC006609 MICROVASCULAR DECOMPRESSION 49500 64350 74250 84150 94050 SVC006610 DEPRESSED FRACTURE ELEVATION AND DECOMPRESSION 38500 50050 57750 65450 73150 SVC006612 CRANIOTOMY AND EXCISION OF INTRAORBITAL TUMOR 49500 64350 74250 84150 94050 SVC006613 V-P SHUNT REMOVAL 14300 18590 21450 24310 27170 SVC006615 CERVICAL DISC ARTHROPLASTY 28600 37180 42900 48620 54340 SVC006616 CRANIOTOMY AND EVACUATION OF HAEMATOMA - SUBDURAL 66530 86490 99790 113100 126400 SVC006618 PROGRAMMABLE VP SHUNT 58740 76360 88110 99860 111610 SVC006619 C.S.F. RHINORRHAEA 31680 41180 47520 53860 60190 SVC006623 RADIO FREQUENCY LESIONIONING FOR TRIGEMINAL NEURALGIA 22000 28600 33000 37400 41800 SVC006624 PERIPHERAL NERVE SURGERY - MAJOR 44000 57200 66000 74800 83600 SVC006625 SPINA BIFIDA SURGERY MAJOR 20900 27170 31350 35530 39710 SVC006629 ORIF MANDIBLE 24090 31320 36140 40950 45770 SVC006630 BRAIN ABSCESS TAPPING (COMPLEX) 11000 14300 16500 18700 20900 SVC006636 SURGICAL MANAGEMENT OF SPINAL DYSRAPHISM (COMPLEX) 83050 107970 124580 141190 157800 SVC006638 CRANIOSYNOSTOSIS (COMPLEX) 60500 78650 90750 102850 114950 SVC006640 MULTIPLE BURR HOLE 44550 57920 66830 75740 84650 SVC006649 CERVICAL LAMINECTOMY & STABILIZATION 51700 67210 77550 87890 98230 SVC006650 CLIPPING OF ANEURYSM-MULTIPLE/COMPLEX 82500 107250 123750 140250 156750 SVC006651 CRANIOTOMY FOR BRAIN TUMOR 56100 72930 84150 95370 106590 SVC006652 CRANIOTOMY FOR BRAIN TUMOR-COMPLEX 66000 85800 99000 112200 125400 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC006653 ENDOSCOPIC EXTENDED APPROACH FOR SKULL BASE TUMOR 71500 92950 107250 121550 135850 SVC012517 RHINOPLASTY 34430 44760 51650 58530 65420 SVC012899 LUMBAR REGION TUMOUR EXCISION 55000 71500 82500 93500 104500 Nuclear Medicine SVC006208 BONE SCAN 7150 7150 9300 10730 12160 13590 SVC006213 DMSA 7260 7260 9440 10890 12340 13790 SVC006215 DTPA 7260 7260 9440 10890 12340 13790 SVC006222 HIDA SCAN (HEPATOBILIARY SCAN) 7200 10800 14040 16200 18360 20520 SVC006228 PARATHYROID SCAN 11550 11550 11550 11550 11550 11550 SVC006231 PET CT SCAN (WITH CONTRAST) 31680 31680 41190 47520 53860 60200 SVC006251 THYROID SCAN 2890 4340 4340 4340 4340 4340 SVC006255 PET CT SCAN (WITHOUT CONTRAST) 23100 23100 30030 34650 39270 43890 SVC006260 GA 68 PSMA PET CT 35200 45760 52800 59840 66880 Obstetrics SVC006692 VAGINAL BIOPSY 4680 6080 7010 7950 8880 SVC006693 VAULT BIOPSY 4680 6080 7010 7950 8880 SVC006694 VULVAL BIOPSY 7150 9300 10730 12160 13590 SVC006696 HYSTEROSCOPY IUCD REMOVAL 18300 23790 27450 31110 34770 SVC006697 REPEAT COMPLETE PERINEAL TEAR REPAIR 9900 12870 14850 16830 18810 SVC006700 VAGINAL HYSTERECTOMY 30800 40040 46200 52360 58520 SVC006701 RETRO PERITONEAL LYMPH NODE BIOPSY 24310 31600 36470 41330 46190 SVC006703 ENDOMETRIOSIS - EXCISION OF SCAR 44770 58200 67160 76110 85060 SVC006707 CYSTOCOELE REPAIR 12540 16300 18810 21320 23830 SVC006709 LAP SALPINGECTOMY 40260 52340 60390 68440 76490 SVC006710 HYSTEROSCOPIC TUBAL CANNULATION 17050 22170 25580 28990 32400 SVC006711 LAMAZE SESSION 3850 5010 5780 6550 7320 SVC006712 LAMAZE SESSION PER SESSION 2200 2860 3300 3740 4180 SVC006713 DIAGNOSTIC HYSTERO LAPAROSCOPY 1870 2430 2810 3180 3550 SVC006714 LAPAROSOCPIC HYSTERECTOMY WITHOUT BSO 40370 52480 60560 68630 76700 SVC006715 LAPAROTOMY - A 5830 7580 8750 9910 11080 SVC006716 LAPAROTOMY - B 39050 50770 58580 66390 74200 SVC006718 OPEN SURGERY FOR ECTOPIC PREGNANCY 34500 44850 51750 58650 65550 SVC006720 LAPAROSCOPIC TUBAL LIGATION 3520 4580 5280 5980 6690 SVC006721 TRANSCERVICAL RESECTION OF ENDOMETRIUM 25080 32600 37620 42640 47650 SVC006723 OVARIAN BIOPSY 9740 12660 14610 16560 18510 SVC006724 ABDOMINAL MYOMECTOMY ( MULTIPLE) 41140 53480 61710 69940 78170 SVC006726 SECOND LOOK LAPAROTOMY 24310 31600 36470 41330 46190 SVC006729 TOTAL LAPROSCOPIC HYSTERECTOMY 50930 66210 76400 86580 96770 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC006734 RIGHT PELVIC LYMPH NODE REPAIR (RPLND) 53790 69930 80690 91440 102200 SVC006737 TOTAL LAPROSCOPIC HYSTERECTOMY +BILATRAL SALPINGO OPHERECTOMY( BSO) 63800 82940 95700 108460 121220 SVC006739 RADICAL HYSTERECTOMY - LAPAROSCOPIC 76120 98960 114180 129400 144630 SVC006740 RETROPERITONEAL LYMPH NODE DISSECTION - LAPAROSCOPIC (RPLND-L) 103600 134680 155400 176120 196840 SVC006742 VAULT PROLAPSE ABDOMINAL REPAIR 44000 57200 66000 74800 83600 SVC006744 BILATRAL SALPINGO OPHERECTOMY (BSO) 69000 89700 103500 117300 131100 SVC006745 TOTAL ABDOMINAL HYSTERECTOMY WITH BILATERAL SALPINGO OOPHORECTOMY 46310 60200 69470 78730 87990 SVC006746 TOTAL ABDOMINAL HYSTERECTOMY (TAH) + BILATERAL SALPINGO-OOPHORECTOMY (BSO)48180 + OMENTECTOMY62630 72270 81910 91540 SVC006747 CYTOREDUCTIVE SURGERY 99110 128840 148670 168490 188310 SVC006748 COLPOSCOPY (DIAGNOSTIC+BIOPSY) 5940 7720 8910 10100 11290 SVC006749 GROIN NODE DISSECTION - B/L 69190 89950 103790 117620 131460 SVC006750 GROIN NODE DISSECTION - U/L 40370 52480 60560 68630 76700 SVC006751 TOTAL ABDOMINAL HYSTERECTOMY (TAH) + BILATERAL SALPINGO-OOPHORECTOMY (BSO)60940 + PELVIC LYMPHADENECTOMY79220 91410 103600 115790 SVC006752 CERVICAL CAUTERIZATION 5500 7150 8250 9350 10450 SVC011693 HEMI VULVECTOMY 22880 29740 34320 38900 43470 SVC011918 TOTAL ABDOMINAL HYSTERECTOMY (TAH) + BILATERAL SALPINGO-OOPHORECTOMY (BSO)48180 + NODE SAMPLING62630 72270 81910 91540 SVC012886 EXCISION OF RUDIMENTARY HORN OF UNICORNUATE UTERUS 55440 72070 83160 94250 105340 SVC012887 EXENTERATION ANTERIOR 82500 107250 123750 140250 156750 SVC012888 EXENTERATION POSTERIOR 82500 107250 123750 140250 156750 SVC012892 LAPAROSCOPIC EXENTERATION (ANTERIOR) 90750 117980 136130 154280 172430 SVC012893 LAPAROSCOPIC EXENTERATION (POSTERIOR) 90800 118100 136200 154400 172600 SVC012894 LAPAROSCOPIC EXENTERATION (TOTAL) 113190 147150 169790 192420 215060 SVC012895 LAPAROSCOPIC OVIRIAN TRANSPOSITION 34430 44760 51650 58530 65420 SVC012896 LAPAROSCOPIC SURGERY FOR CARCINOMA OF OVARY 33000 42900 49500 56100 62700 SVC012898 LASER EXCISION OF VAGINAL LESION 14190 18450 21290 24120 26960 SVC012903 OMENTECTOMY + PERITONECTOMY 60940 79220 91410 103600 115790 SVC012904 OVARIAN TRANSPOSITION 28930 37610 43400 49180 54970 SVC012905 PELVIC LYMPHADENECTOMY 40370 52480 60560 68630 76700 SVC012906 PERITONECTOMY 24310 31600 36470 41330 46190 SVC012911 Radical Trachelectomy - Laparoscopic 40370 52480 60560 68630 76700 SVC012912 RADICAL TRACHELECTOMY + LAPAROSCOPIC PELVIC LYMPHADENECTOMY 76120 98960 114180 129400 144630 SVC012913 RADICAL TRACHELECTOMY + PELVIC LYMPHADENECTOMY 72380 94090 108570 123050 137520 SVC012914 RADICAL VULVECTOMY + INGUINO FEMORAL LYMPHADENECTOMY - B/L 92180 119830 138270 156710 175140 SVC012915 RADICAL VULVECTOMY + INGUINO FEMORAL LYMPHADENECTOMY - U/L 63250 82230 94880 107530 120180 SVC012917 SURGICAL STAGING FOR ENDOMETRIAL CANCER 72380 94090 108570 123050 137520 SVC012918 TAH & LAP SALPINGO - OOPHERECTOMY 24310 31600 36470 41330 46190 SVC012919 TOTAL ABDOMINAL HYSTERECTOMY (TAH) + BILATERAL SALPINGO-OOPHORECTOMY (BSO)72380 + OMENTO 94090+ NODE DISSECTION108570 123050 137520 SVC012920 TOTAL ABDOMINAL HYSTERECTOMY (TAH) + BILATERAL SALPINGO-OOPHORECTOMY (BSO)72380 + PELVIC LYMPHADENECTOMY94090 108570 123050 + PARA-AORTIC137520 LYMPHADENECTOMY Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC012922 TUBOPLASTY 12870 16730 19310 21880 24450 SVC012923 USG GUIDED DILATATION & CURETTAGE (D&C) 17380 22590 26070 29550 33020 SVC012924 VAGINECTOMY 23870 31030 35810 40580 45350 Opthalmology PKG004330 PHACOEMULSFICATION PKG 26620 34610 39930 45250 50580 PKG009442 PHACO-MICRO INCISION CATARACT SURGERY-(MICS)-(PRELOADED)-LENS EXTRA - PKG 33000 42900 49500 56100 62700 SVC006955 EVISCERATION 11000 14300 16500 18700 20900 SVC006956 EXCISION OF PTERYGIUM WITH LIMBAL AUTOGRAFT 5280 6860 7920 8980 10030 SVC006957 LATERAL ORBITOTOMY 34870 45330 52310 59280 66250 SVC006958 LENSECTOMY 19690 25600 29540 33470 37410 SVC006959 LID RECONSTRUCTION 22220 28890 33330 37770 42220 SVC006960 PROBING & SYRINGING OF THE NASOLACRIMAL DUCT 3080 4000 4620 5240 5850 SVC006961 REMOVAL OF CHALAZION 2420 3150 3630 4110 4600 SVC006963 FUNDUS FLUROSCEIN ANGIOGRAM 2200 2200 2860 3300 3740 4180 SVC006964 HUMPHREY VISUAL FIELD EXAMINATION 1170 1170 1520 1750 1980 2220 SVC006965 DACRYOCYSTORHINOSTOMY 18700 24310 28050 31790 35530 SVC006968 FUNDOSCOPY 880 880 1140 1320 1500 1670 SVC006969 PHACOEMULSIFICATION 12100 15730 18150 20570 22990 SVC006970 CYCLOCRYOTHERAPY (CCT) 3300 4290 4950 5610 6270 SVC006971 INTRAVITREAL INJECTION 1540 2000 2310 2620 2930 SVC006972 SUTURE REMOVAL(EYE) 910 1190 1370 1550 1730 SVC006974 ORBITAL EXENTERATION 23870 31030 35810 40580 45350 SVC006975 LPS RESECTION(PTOSIS SURGERY) 17050 22170 25580 28990 32400 SVC006976 LID RECONSTRUCTION MINOR 11000 14300 16500 18700 20900 SVC006978 EXCISION OF EYELID MASS 16500 21450 24750 28050 31350 SVC006979 TARSORRHAPHY 4400 5720 6600 7480 8360 SVC006980 ENUCLEATION 15950 20740 23930 27120 30310 SVC006981 TRABECULECTOMY + MITOMYCIN 18150 23600 27230 30860 34490 SVC006982 AVASTIN INJECTION 4620 6010 6930 7850 8780 SVC006987 COLOUR VISION 220 290 330 370 420 SVC006995 ORTHOPTIC EXERCISE 1870 2430 2810 3180 3550 SVC006996 PACHYMETRY 880 1140 1320 1500 1670 SVC006998 PUNCTUM OCLUSSION 3580 4650 5360 6080 6790 SVC007005 SQUINT EVALUATION 1650 2150 2480 2810 3140 SVC007023 EXCISSION OF PTERYGIUM 5500 7150 8250 9350 10450 SVC007026 GENERAL ANAESTHESIA/EXAMINATION UNDER ANAESTHESIA 3300 4290 4950 5610 6270 SVC007036 MEMBRANECTOMY 19690 25600 29540 33470 37410 SVC007043 PTERYGIUM 4400 5720 6600 7480 8360 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC007044 PTERYGIUM EXCISION WITH CONJUNCTIVAL AUTOGRAFTING 9900 12870 14850 16830 18810 SVC007059 XANTHOMA EXCISION (LA) (PER EYE) 2310 3000 3470 3930 4390 SVC007060 ABSCESS DRAINAGE OF LID 3800 4930 5690 6450 7210 SVC007063 CAPSULOTOMY 4400 5720 6600 7480 8360 SVC007064 CORNEO SCLERAL LACERATION REPAIR 19800 25740 29700 33660 37620 SVC007065 CONJUNTIVAL FLAP 8360 10870 12540 14210 15880 SVC007066 PTERYGIUM EXCISION WITH CONJUNCTIVAL LIMBAL AUTOGRAFTING + AMNIOTIC MEMBRANE9900 GRAFTING12870 14850 16830 18810 SVC007067 SUPERFICIAL FOREIGHN BODY REMOVAL (OT) 3300 4290 4950 5610 6270 SVC007071 B SCAN SONOGRAPHY(ONE EYE) 880 880 1140 1320 1500 1670 SVC007072 B SCAN SONOGRAPHY(BOTH EYE) 1650 1650 2150 2480 2810 3140 SVC007075 ECTROPIAN 13750 17880 20630 23380 26130 SVC007076 ENTROPION 14080 18300 21120 23940 26750 SVC007077 LASIK ONE EYE 31240 40610 46860 53110 59360 SVC007078 SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY MACULA 3850 5010 5780 6550 7320 SVC007079 SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY RNFL 4620 6010 6930 7850 8780 SVC007080 SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY CORNEA 3850 5010 5780 6550 7320 SVC007088 SQUINT UNDER GA - SIMPLE 16500 21450 24750 28050 31350 SVC007089 SQUINT UNDER GA - COMPLEX 20350 26460 30530 34600 38670 SVC007090 TRABECULECTOMY 15180 19730 22770 25810 28840 SVC007091 TRABECULOTOMY 16500 21450 24750 28050 31350 SVC007095 CORNEAL TEAR SUTURING - MINOR 13200 17160 19800 22440 25080 SVC007107 TONOMETRY 110 140 170 190 210 SVC007110 DIURNAL VARIATION 990 1290 1490 1680 1880 SVC007111 FUNDUS PHOTOGRAPHY 950 1240 1430 1620 1810 SVC007112 ULTRASOUND A-SCAN 240 310 360 410 460 SVC007113 CONJUNCTIVAL LACERATION REPAIR 4400 5720 6600 7480 8360 SVC007114 NYSTAGMUS SURGERY 22000 28600 33000 37400 41800 SVC007115 SYRINGING OF EYE 500 640 740 840 940 SVC007116 EXPLORATION SYRINGING TEAR DUCTS(OPD) 1650 2150 2480 2810 3140 SVC007117 TARSORRHAPHY-RELEASE 880 1140 1320 1500 1670 SVC007119 SUTURE LESS VITRECTOMY 34500 44840 51740 58640 65540 SVC007331 SECONDARY SUTURING 3300 4290 4950 5610 6270 SVC007563 SYNDACTY RELEASE SIMPLE 16130 20960 24190 27410 30640 Orthopedics PKG003071 TOTAL HIP REPLACEMENT PKG 169400 220220 254100 287980 321860 PKG007185 TOTAL HIP REPLACEMENT-B/L PKG 231000 300300 346500 392700 438900 PKG004397 TOTAL KNEE REPLACEMENT (B/L) - A PKG 214500 278850 321750 364650 407550 PKG004417 TOTAL KNEE REPLACEMENT (U/L) - A PKG 176000 228800 264000 299200 334400 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite PKG004483 ACL RECONSTRUCTION_PKG 79750 103680 119630 135580 151530 PKG007143 MCL RECONSTRUCTION PKG 79750 103680 119630 135580 151530 PKG007152 PCL RECONSTRUCTION PKG 79750 103680 119630 135580 151530 SVC007128 ADDUCTOR TENOTOMY 7460 9700 11190 12680 14170 SVC007129 ADDUCTOR TENOTOMY + OBTURATOR NEURECTOMY 11880 15440 17820 20200 22570 SVC007134 ASPIRATION OF JOINTS 1450 1890 2180 2470 2760 SVC007142 CORE DECOMPRESSION 15950 20740 23930 27120 30310 SVC007145 CORRECTIVE OSTEOTOMY 18150 23600 27230 30860 34490 SVC007156 FUNCTIONAL CAST BRACING 5670 7360 8500 9630 10760 SVC007162 HIP SPICA 6220 8080 9320 10570 11810 SVC007163 IMPLANT REMOVAL NAILS AND PLATES 2750 3580 4130 4680 5230 SVC007164 IMPLANT REMOVAL WIRE AND SCREWS 4750 6180 7130 8080 9030 SVC007165 INGROWING TOE NAIL 2630 3420 3950 4470 5000 SVC007166 INTRAARTICULAR INJECTION 2400 3120 3600 4080 4560 SVC007168 LARGE JOINT ARTHRODESIS 27830 36180 41750 47310 52880 SVC007170 MCL RECONSTRUCTION 37400 48620 56100 63580 71060 SVC007178 OPEN SYNOVECTOMY 15730 20450 23600 26740 29890 SVC007179 ORIF PELVIS AND ACETABULUM 52270 67950 78410 88860 99320 SVC007183 PATELLECTOMY 13200 17160 19800 22440 25080 SVC007184 PCL RECONSTRUCTION 37400 48620 56100 63580 71060 SVC007186 PLASTER REMOVAL 690 900 1040 1180 1320 SVC007187 RADIAL HEAD REPLACEMENT 18150 23600 27230 30860 34490 SVC007195 SKELETAL TRACTION 4290 5580 6440 7290 8150 SVC007197 STRAPPING 650 840 970 1100 1230 SVC007198 SUBACROMIAL DECOMPRESSION 19800 25740 29700 33660 37620 SVC007200 TENDOACHILLES REPAIR 11660 15160 17490 19820 22150 SVC007204 TENDON REPAIR SINGLE 9300 12080 13940 15800 17660 SVC007209 TOTAL HIP REPLACEMENT 69960 90950 104940 118930 132920 SVC007210 TOTAL KNEE REPLACEMENT - BILATERAL 99000 128700 148500 168300 188100 SVC007211 TOTAL SHOULDER REPLACEMENT 38830 50480 58250 66010 73780 SVC007212 TRIPLE ARTHRODESIS 19910 25880 29870 33850 37830 SVC007213 UNICONDYLAR KNEE REPLACEMENT 32670 42470 49010 55540 62070 SVC007214 APPLICATION OF POP CAST - BOTH LIMBS 4160 5410 6240 7070 7900 SVC007215 APPLICATION OF POP CAST - SINGLE LIMB 2510 3260 3760 4260 4770 SVC007218 TOTAL KNEE REPLACEMENT - UNILATERAL 79750 103680 119630 135580 151530 SVC007219 CLAVICULAR BRACE APPLICATION 1210 1570 1820 2060 2300 SVC007221 ARTHROSCOPY - DIAGNOSTIC 13200 17160 19800 22440 25080 SVC007233 APPLICATION OF EXTERNAL FIXATOR (ILLIZAROV) 30250 39330 45380 51430 57480 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC007244 CLOSED REDUCTION OF FOREARM (COLLES) FRACTURE 6150 8000 9230 10460 11690 SVC007247 CLOSED REDUCTION OF METACARPAL FRACTURES AND PHALANGEAL FRACTURES 8750 11370 13120 14870 16620 SVC007257 MANIPULATION AND SKELETAL TRACTION FOR HIP DISLOCATION 19030 24740 28550 32350 36160 SVC007261 INTERNAL FIXATION OF SHAFT HUMERUS FRACTURE 21670 28170 32510 36840 41170 SVC007264 APPLICATION OF PLASTER CAST(UPPER LIMB /LOWER LIMB ) 3360 4360 5030 5700 6370 SVC007266 MENISCECTOMY 20350 26460 30530 34600 38670 SVC007273 OPEN REDUCTION & INTERNAL FIXATION (ORIF) FEMUR 26660 34660 40000 45330 50660 SVC007274 OPEN REDUCTION OF DISTAL RADIUS FRACTURE 15730 20450 23600 26740 29890 SVC007275 OPEN REDUCTION OF ELBOW FRACTURES 44000 44000 44000 44000 44000 SVC007288 CLOSED MANIPULATION OF SHOULDER DISLOCATION 10780 14010 16170 18330 20480 SVC007289 SYNOVIAL BIOPSY 6800 8840 10200 11560 12920 SVC007291 ARTHROTOMY 10450 13590 15680 17770 19860 SVC007292 JOINT REPLACEMENT(ARTHROPLASTY)-HAND 31350 40760 47030 53300 59570 SVC007295 BONE BIOPSY DEEP 3430 4460 5150 5830 6520 SVC007299 BONE BIOPSY SUPERFICIAL 5670 7360 8500 9630 10760 SVC007300 CLOSE REDUCTION OF FRACTURES 19360 25170 29040 32910 36780 SVC007302 DEEP DEBRIDEMENT AND SUTURING 15680 20380 23510 26650 29780 SVC007303 SUPERFICIAL DEBRIDEMENT AND SUTURING 7770 10100 11660 13210 14760 SVC007306 APPLICATION OF EXTERNAL FIXATOR( OPEN FRACTURES) 23760 30890 35640 40390 45140 SVC007312 BONE GRAFTING 20860 27110 31280 35460 39630 SVC007313 SURGICAL MANAGEMENT OF SCAPHOID FRACTURES 15730 20450 23600 26740 29890 SVC007324 CLOSED REDUCTION AND INTERNAL FIXATION OF TIBIA FRACTURE 4130 5360 6190 7010 7840 SVC007325 CORRECTION OF TOE DEFORMITY 7150 9300 10730 12160 13590 SVC007326 EXTERNAL FIXATION - PELVIS 18150 23600 27230 30860 34490 SVC007332 DEBRIDEMENT AND SUTURING 6540 6540 8500 9810 11120 12430 SVC007334 SOFT TISSUE RELEASE 14740 19160 22110 25060 28010 SVC007336 SKIN TRACTION 550 720 830 940 1050 SVC007339 PERCUTANEOUS TENOTOMY - MULTIPLE 4290 5580 6440 7290 8150 SVC007340 PERCUTANEOUS TENOTOMY - SINGLE 4290 5580 6440 7290 8150 SVC007341 ACL RECONSTRUCTION 39930 51910 59900 67880 75870 SVC007350 OPEN BIOPSY (LARGE) 16500 21450 24750 28050 31350 SVC007353 FIXATION OF CARPAL FRACTURES 15730 20450 23600 26740 29890 SVC007363 SMALL JOINT REPLACEMENTS 19800 25740 29700 33660 37620 SVC007369 LOOSE BODY REMOVAL 18150 23600 27230 30860 34490 SVC007373 SUTURING - MINOR 710 710 920 1070 1210 1350 SVC007374 SUTURING - INTERMEDIATE 880 1320 1720 1980 2240 2510 SVC007375 SUTURING - MAJOR 1770 1770 2300 2660 3010 3360 SVC007376 EXCISION OF RADIAL HEAD 12100 15730 18150 20570 22990 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC007377 TENSION BAND WIRING 7700 10010 11550 13090 14630 SVC007379 OPEN REDUCTION & INTERNAL FIXATION - COMPLEX 17710 23020 26570 30110 33650 SVC007380 REMOVAL OF LARGE IMPLANTS 18150 23600 27230 30860 34490 SVC007381 SPINAL OPERATION (LAMINECTOMY+DISCECTOMY) 58080 75500 87120 98740 110350 SVC007383 SOFT TISSUE OPERATIONS FOR C.T.E.V. 16500 21450 24750 28050 31350 SVC007384 TENSION BAND & OTHER FORM & PATELLAR RECONSTRUCTION OR OLECRANON FRACTURES20860 27120 31290 35460 39630 SVC007387 ABOVE ELBOW AMPUTATION 18150 23600 27230 30860 34490 SVC007388 ARTHRODESIS OF MINOR JOINTS 12980 16870 19470 22070 24660 SVC007389 EXCISION OF BONE TUMOURS - DEEP 15950 20740 23930 27120 30310 SVC007396 EXCISION OF CORN 4290 5580 6440 7290 8150 SVC007397 POP CAST BELOW ELBOW 2200 2200 2860 3300 3740 4180 SVC007398 POP CAST ABOVE ELBOW 3470 3470 4510 5210 5900 6590 SVC007399 POP CAST BELOW KNEE 2310 2310 3000 3470 3930 4390 SVC007400 POP CAST ABOVE KNEE 3470 5210 6770 7810 8850 9890 SVC007406 SCOTCH CAST REMOVAL 1270 1270 1640 1900 2150 2400 SVC007407 PATELLAR TENDON BEARING (PTB) CAST 3960 3960 5150 5940 6730 7520 SVC007408 INGROWING TOE NAIL B/L 4400 4400 5720 6600 7480 8360 SVC007421 AROUND SHOULDER -ACROMIOCLAVICULAR JOINT TBW 19030 24740 28550 32350 36160 SVC007439 AROUND SHOULDER -ACROMIOCLAVICULAR JOINTS PLATING 26180 34030 39270 44510 49740 SVC007445 DISTAL TIBIA & FABULA-EXTERNAL FIXATOR 11660 15160 17490 19820 22150 SVC007459 SPINE-VERTEBROPLASTY (EACH LEVEL) 26950 35040 40430 45820 51210 SVC007460 SEQUESTRECTOM + CURETTAGE UPPER LIMB BONE 14300 18590 21450 24310 27170 SVC007461 CALCENEUM / TALUS /TARSAL BONE-PLATE FIXATION 20350 26460 30530 34600 38670 SVC007482 SEQUESTRECTOM + CURETTAGE LOWER LIMB BONE 20350 26460 30530 34600 38670 SVC007488 POSTERIOR INSTRUMENTATION 46530 60490 69800 79100 88410 SVC007489 POST.DECOMPRESSION 26950 35040 40430 45820 51210 SVC007490 ACL AND MENISCECTOMY 34650 45050 51980 58910 65840 SVC007491 THROCHANTERIC/ SUBTHROCHANTERIC FRACTURE FEMUR (DSH/DCH/PFN) 36430 47360 54650 61930 69220 SVC007492 INTERLOCKING NAIL TIBIA/ FEMUR 26950 35040 40430 45820 51210 SVC007496 CTE/CLUB FOOT MANIPULATIONS 13200 17160 19800 22440 25080 SVC007517 TIBIA FRACTURE PROXIMAL/ MIDDLE/ DISTAL - ORIF/ CRIF WITH NAILING/ LOCKING 29590 38470 44390 50300 56220 SVC007518 OPEN REDUCTION INTERNAL FIXATION CLAVICLE FRACTURE 26180 34030 39270 44510 49740 SVC007521 OPEN REDUCTION INTERNAL FIXATION (ORIF) BOTH BONE FOREARM 18150 23600 27230 30860 34490 SVC007528 K WIRE REMOVAL UNDER GA 3630 4720 5450 6170 6900 SVC007529 INTRALESIONAL INJECTION FOR BONE 1890 2460 2840 3210 3590 SVC007531 IMPLANT REMOVAL (K WIRES) 2640 3430 3960 4490 5020 SVC007533 AMPUTATION - ABOVE KNEE/BELOW KNEE/THROUGH ARM/THROUGH FOREARM/THROUGH17820 THIGH 23170 26730 30290 33860 SVC007536 DEBRIDEMENT - SMALL 7260 9440 10890 12340 13790 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC007538 EXCISION GANGLION 3630 4720 5450 6170 6900 SVC007539 MAJOR TENDON TRANSFER 30360 39470 45540 51610 57680 SVC007541 TENDON REPAIR - SINGLE 26000 33810 39010 44210 49410 SVC007542 TRIGGER FINGER RELEASE 7150 9300 10730 12160 13590 SVC007545 HEMIPELVECTOMY 62480 81220 93720 106220 118710 SVC007549 VASCULARISED FIBULA GRAFTING FOR BONE DEFECTS 34100 44330 51150 57970 64790 SVC007554 OPEN REDUCTIONHIP 20020 26030 30030 34030 38040 SVC007556 QUADRICEPS PLASTY 14740 19160 22110 25060 28010 SVC007561 HIP/ SHOULDER DISARTICULATION 26620 34610 39930 45250 50580 SVC007562 CURETTAGE 9300 12080 13940 15800 17660 SVC007568 SEQUES TRECTOMY 20900 27170 31350 35530 39710 SVC007571 TORTICOLLIS MONOPOLAR RELEASE 13200 17160 19800 22440 25080 SVC007588 ABSCESS DRAINAGE / DEBRIDEMENT - LARGE 21780 28310 32670 37030 41380 SVC007589 ABSCESS DRAINAGE / DEBRIDEMENT - SMALL 4160 5410 6240 7070 7900 SVC007593 DIAGNOSTIC ARTHROSCOPY - SHOULDER 16510 21460 24770 28070 31370 SVC007594 INTERLOCK NAIL REMOVAL 10410 13530 15610 17690 19770 SVC007595 K WIRE REMOVAL (OPD) > 2 1400 1820 2100 2370 2650 SVC007596 LIGAMENT RECONSTRUCTION 11550 15020 17330 19640 21950 SVC007598 SYNOVECTOMY - ELBOW 14740 19160 22110 25060 28010 SVC007599 SYNOVECTOMY - WRIST / ANKLE 13200 17160 19800 22440 25080 SVC007600 REMOVAL OF EXOSTOSIS - DEEP 13200 17160 19800 22440 25080 SVC007601 REMOVAL OF EXOSTOSIS - SUPERFICIAL 6220 8080 9320 10570 11810 SVC007602 BIOPSY / LAVAGE / ARTHROTOMY - HIP / SHOULDER 11660 15160 17490 19820 22150 SVC007603 AC JOINT (ISOLATED) - ORIF 16500 21450 24750 28050 31350 SVC007604 AMPUTATION - SINGLE DIGIT HAND/ FOOT 6050 7870 9080 10290 11500 SVC007605 ANTERIOR APPROACH AND ORIF 2 LEVELS - SPINE 46200 60060 69300 78540 87780 SVC007606 ARTHROSCOPIC DEBRIDEMENT 42130 54770 63200 71620 80050 SVC007608 ARTHROSCOPY- KNEE JOINT 19800 25740 29700 33660 37620 SVC007609 BONE GRAFTING ONLY (IN NON UNION) 26400 34320 39600 44880 50160 SVC007610 BUDDY STRAPPING-STS 740 960 1110 1250 1400 SVC007612 CAST AE/AK (WITHOUT REDUCTION) 3010 3910 4520 5120 5720 SVC007616 CAST BK/BE (WITH REDUCTION) (ORTHO) 3820 4970 5730 6490 7260 SVC007629 DISCETOMY - MICRODISCECTOMY 45830 59570 68740 77900 87070 SVC007630 DISTAL RADIUS K-WIRE WITH EXTERNAL FIXATION -FOREARM 7700 10010 11550 13090 14630 SVC007632 EPIDURA INJECTION / CAUDAL BLOCK 11000 14300 16500 18700 20900 SVC007633 EXCISION BURSA - KNEE JOINT /BAKERS CYST 10410 13530 15610 17690 19770 SVC007634 EXTERNAL FIXATOR WIRE (LLIZAROV) ADJUSTMENT 3630 4720 5450 6170 6900 SVC007635 FACETAL INJECTION - SPINE / EPIDURAL INJECTION (ORTHO) 12320 16020 18480 20940 23410 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC007636 FASCIOTOMY - LOWER LIMB 12870 16730 19310 21880 24450 SVC007637 FASCIOTOMY - UPPER LIMB 11660 15160 17490 19820 22150 SVC007639 GANGLION - FOOT 6220 8080 9320 10570 11810 SVC007640 ILIZAROV BONE TRANSPORT FOR GAP NON UNION - LONG BONE 33000 42900 49500 56100 62700 SVC007642 INTERLOCK NAILING - FEMUR / HUMERUS 27280 35460 40920 46380 51830 SVC007643 INTERLOCK NAILING - SC 27280 35460 40920 46380 51830 SVC007644 INTERLOCK NAILING- TIBIA/FIBULA 26950 35040 40430 45820 51210 SVC007645 K NAIL / V NAIL/ SQUARE NAIL REMOVAL 7040 9150 10560 11970 13380 SVC007647 LCS DECOMPRESSION & FUSION (>2 LEVELS) 38830 50480 58250 66010 73780 SVC007649 MALLET FINGER REPAIR / FIXATION 6220 8080 9320 10570 11810 SVC007650 MALUNION CORRECTION WITH PLATE 27280 35460 40920 46380 51830 SVC007653 MUA - FRACTURE ANKLE 7040 9150 10560 11970 13380 SVC007654 MUA - FRACTURE FEMUR IN CHILD 10410 13530 15610 17690 19770 SVC007656 MUA & K-WIRE FIXATION - FOREARM / TIBIA / FIBULA 13200 17160 19800 22440 25080 SVC007657 MUA & PINNING - SHOULDER / HIP 7700 10010 11550 13090 14630 SVC007658 MUA FOREARAM / DISTAL RADIUS - EXTERNAL FIXTOR 9300 12080 13940 15800 17660 SVC007659 MUA - SHOULDER / HUMERUS/ ANKLE / FOOT 6960 9050 10440 11840 13230 SVC007660 NAIL DYNAMIZATION -TIBIA/FIBULA/FEMUR/HUMERUS 3630 4720 5450 6170 6900 SVC007661 NAILING WITH BONE GRAFTING - NON UNION TIBIA 23870 31030 35810 40580 45350 SVC007663 NON UNION ORIF WITH BONE GRAFTING - CLAVICLE 23870 31030 35810 40580 45350 SVC007664 NON UNION SHAFT - FEMUR / BOTH BONES FOREARM 30690 39900 46040 52170 58310 SVC007665 NON UNION SHAFT - HUMERUS 30690 39900 46040 52170 58310 SVC007666 OLD NEGLECTED DISLOCATION SURGERY - ELBOW / SHOULDER / HIP 27280 35460 40920 46380 51830 SVC007667 OPEN REDUCTION IN FRACTURE DISLOCATION- FOOT 13200 17160 19800 22440 25080 SVC007668 ORIF - LATERAL MALLEOLUS / MEDIAL MALLEOLOUS 13200 17160 19800 22440 25080 SVC007670 ORIF - SINGLE BONE - FOREARM 11660 15160 17490 19820 22150 SVC007672 ORIF - SUPRACONDYLAR - HUMERUS / INTERCONDYLAR HUMERUS -INTER 20330 26430 30490 34560 38620 SVC007674 ORIF PATELLA 13200 17160 19800 22440 25080 SVC007675 ORIF - SHOULDER / UPPER END HUMERUS 19800 25740 29700 33660 37620 SVC007676 OSTEOTOMY - ANKLE 13200 17160 19800 22440 25080 SVC007677 OSTEOTOMY METATARSAL / TARSAL - FOOT - MULTIPLE 14740 19160 22110 25060 28010 SVC007678 OSTEOTOMY - TIBIA/FIBULA/HTO 22300 28990 33450 37900 42360 SVC007679 PERIARTICULAR FRACTURE KNEE (UPPER END TIBIA DISTAL FEMUR) 23870 31030 35810 40580 45350 SVC007681 PLIF - SPINE 55840 72590 83750 94920 106090 SVC007682 POP SLAB WITHOUT REDUCTION - AE /AK / CYLINDER 1540 2000 2310 2620 2930 SVC007684 POP SLAB WITHOUT REDUCTION - BEPOP SLAB WITHOUT REDUCTION - BE / BK 1040 1350 1560 1770 1980 SVC007685 REPAIR OF QUADRICEPS OR PATELLAR TENDON 11660 15160 17490 19820 22150 SVC007688 RJ BADAGE / STRAPPING 1270 1640 1900 2150 2400 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC007689 ROTATOR CUFF REPAIR - SHOULDER (ARTHROSCOPIC/MINI OPEN) 38190 49650 57290 64930 72560 SVC007691 SPINAL FRACTURE - PSTERIOR FIXATION WITH FUSION 46530 60490 69800 79100 88410 SVC007692 SUPRACONDYLAR FEMORAL OSTEOTOMY FIXATION 23870 31030 35810 40580 45350 SVC007693 SUPRACONDYLAR FRACTURE - MUA & WIRE- HUMERUS 11660 15160 17490 19820 22150 SVC007696 TUMOUR RESECTION & GRAFT - OTHER SITES (LARGE) 34100 44330 51150 57970 64790 SVC007697 UL/LL ACUTE OSTEOMYLITUS SURG - DECOMPRESSION 13200 17160 19800 22440 25080 SVC007699 ORTHOPAEDIC WOUND DEBRIDEMENT - MEDIUM 19510 25370 29270 33170 37080 SVC007706 LOOSE FOREIGN BODY REMOVAL - DEEP 9680 12580 14520 16460 18390 SVC007707 LOOSE FOREIGN BODY REMOVAL - SUPERFICIAL 6050 7870 9080 10290 11500 SVC007708 DISARTICULATION - ELBOW/WRIST/ANKLE 21780 28310 32670 37030 41380 SVC007709 DISARTICULATION - SMALL JOINT 12100 15730 18150 20570 22990 SVC007710 TRANS ARTICULAR FIXATION 15290 19880 22940 25990 29050 SVC007711 BONE CURRETAGE - SMALL 7260 9440 10890 12340 13790 SVC007712 FASCIOTOMY - HAND/FEET 8470 11010 12710 14400 16090 SVC007713 CORRECTIVE OSTEOTOMY (MINOR) 7260 9440 10890 12340 13790 SVC007714 HEMI ARTHROPLASTY/ BIPOLAR HIP/SHOULDER 31940 41530 47920 54300 60690 SVC007715 EXTERNAL FIXATOR (LARGE BONES) 21780 28310 32670 37030 41380 SVC007721 SINGLE-EVENT MULTILEVEL SURGERY (SEMLS) MEDIUM 31350 40760 47030 53300 59570 SVC007722 SINGLE-EVENT MULTILEVEL SURGERY (SEMLS) LARGE 48950 63640 73430 83220 93010 SVC007723 SINGLE-EVENT MULTILEVEL SURGERY (SEMLS) SMALL 19800 25740 29700 33660 37620 SVC007724 HALO/CX TRACTION/SKELETAL TRACTION APPLICATION 11000 14300 16500 18700 20900 SVC007725 RF. LESION FOR FACET JOINT PAIN SYNDROME 19530 25380 29290 33190 37100 SVC007726 LUMBAR/CS DECOMPRESS FIXATION 1 LEVEL 28950 37640 43430 49220 55010 SVC007727 LUMBAR/CS DECOMPRESS FIXATION 2 LEVEL 38370 49880 57550 65230 72900 SVC007728 LUMBAR/CS DECOMPRESS FIXATION 3 LEVEL 47800 62130 71690 81250 90810 SVC007729 EXCISION OF BONE TUMOURS 34650 45050 51980 58910 65840 SVC011632 BIPOLAR RELEASE TORTICOLLIS 17600 22880 26400 29920 33440 SVC012927 BIPOLAR RELEASE TORTICOLLIS WITH Z PLASTY 22000 28600 33000 37400 41800 Others SVC000332 EXCISION OF FIBROADENOMA 13420 17450 20130 22810 25500 SVC000477 RESUTURING OF WOUND 14520 18880 21780 24680 27590 SVC000578 ARCH BAR REMOVAL 5720 7440 8580 9720 10870 SVC001364 MICRONEEDLING FOR PRP_GST 27500 35750 41250 46750 52250 SVC001365 MICRONEEDLING FOR HYPERPIGMENTATION_GST 4130 5360 6190 7010 7840 SVC001570 HAIR REDUCTION-CHIN_GST 28930 37610 43400 49180 54970 SVC010633 DIAGNOSTIC THORACOSCOPY 28050 36470 42080 47690 53300 SVC010634 EXPLORATORY THORACOTOMY 24970 32460 37460 42450 47440 SVC010637 RIGID BRONCHOSCOPY 15620 20310 23430 26550 29680 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC010641 TRACHEAL RECONSTRUCTIONS 30690 39900 46040 52170 58310 SVC010653 THORACOSCOPIC PERICARDIAL WINDOW 29590 38470 44390 50300 56220 Physiotherapy PKG016345 CARDIAC REHABILITATION (36 SESSIONS)_PKG 19800 25740 29700 33660 37620 PKG016346 PULMONARY REHABILITATION (30 SESSION)_PKG 19800 25740 29700 33660 37620 PKG016347 NEURO REHABILITATION (24 SESSIONS)_PKG 18900 24570 28350 32130 35910 PKG016348 ORTHOPEDIC REHABILITATIO(10 VISITS) PKG 7560 9830 11340 12850 14360 PKG016349 ORTHOPEDIC REHABILITATIO(20 VISITS) PKG 15840 20590 23760 26930 30100 SVC008018 EXERCISE & MODALITIES 290 290 370 430 490 540 SVC008019 CHEST PHYSIOTHERAPY (CPT) 230 230 300 350 390 440 SVC008020 CHEST PHYSIOTHERAPY + ROM EXERCISES 320 320 410 480 540 610 SVC008021 CONTINUOUS PASSIVE MOVEMENT (CPM) 320 320 410 480 540 610 SVC008022 CRYO THERAPY 260 260 340 400 450 500 SVC008023 ELECTRICAL MUSCLE STIMULATION (EMS) 290 290 370 430 490 540 SVC008024 GAIT TRAINING 260 260 340 400 450 500 SVC008025 INFRA RED RAYS THERAPY (IRR) 200 200 260 300 340 380 SVC008026 INTERFERENTIAL THERAPY (IFT) 280 280 360 410 470 520 SVC008027 LASER THERAPY 330 330 430 500 560 630 SVC008028 MOIST HEAT THERAPY 260 260 340 400 450 500 SVC008029 NEURO REHABILITATION 880 880 1140 1320 1500 1670 SVC008030 POSTURAL AWARENESS THERAPY 260 260 340 400 450 500 SVC008031 PRE & POST NATAL EXERCISES 420 420 540 630 710 790 SVC008032 SHORT WAVE DIATHERMY (SWD) 280 280 360 410 470 520 SVC008033 SUSPENSION THERAPY 260 260 340 400 450 500 SVC008034 TILT TABLE THERAPY 260 260 340 400 450 500 SVC008035 TRACTION (CERVICAL/ LUMBAR) 310 310 400 460 520 590 SVC008036 TRANSCUTANEOUS NERVE STIMULATION (TENS) 280 280 360 410 470 520 SVC008037 ULTRA SOUND THERAPY (UST) 240 240 310 360 410 460 SVC008038 ULTRA VIOLET THERAPY (UVR) 260 260 340 400 450 500 SVC008039 WAX THERAPY 330 330 430 500 560 630 SVC008040 DEEP TISSUE RELEASE (DTR) 230 230 300 350 390 440 SVC008041 FALLS PREVENTION AND JOINT PROTECTION 260 260 340 400 450 500 SVC008042 KINESIOTAPING (KT) ANKLE 990 990 1290 1490 1680 1880 SVC008043 KINESIOTAPING (KT) KNEE 990 990 1290 1490 1680 1880 SVC008044 KINESIOTAPING (KT) NECK 990 990 1290 1490 1680 1880 SVC008045 KINESIOTAPING (KT) SHOULDER 990 990 1290 1490 1680 1880 SVC008046 KINESIOTAPING (KT) SPINE 990 990 1290 1490 1680 1880 SVC008047 MRP 230 230 300 350 390 440 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008048 MYOFASCIAL RELEASE (MFR) 230 230 300 350 390 440 SVC008049 MYOTHERAPY 230 230 300 350 390 440 SVC008050 NEURAL MOBILIZATION 230 230 300 350 390 440 SVC008051 NEURO REHABILITATION FOR CEREBRAL PALSY 260 260 340 400 450 500 SVC008052 NEUROREHABILITATION (ADULT) PACKAGE 690 690 900 1040 1180 1320 SVC008053 PAIN MANAGEMENT 720 720 930 1070 1220 1360 SVC008054 PHYSIO PACKAGE FOR ITU/ICU PATIENTS 530 530 690 790 900 1000 SVC008055 PHYSIO PACKAGE FOR WARD PATIENTS 420 420 540 630 710 790 SVC008056 PNF 230 230 300 350 390 440 SVC008057 PULMONARY FUNCTION TEST / LUNG FUNCTION TEST 1200 1200 1560 1800 2040 2280 SVC008058 VESTIBULAR REHABILITATION 250 250 330 380 430 480 SVC008059 INTRA MUSCULAR STIMULATION 1320 1720 1980 2240 2510 SVC008060 PHYSIOTHERAPY REHABILITATION PROGRAM 660 660 860 990 1120 1250 SVC008061 EXERCISE & MODALITIES - 2 290 290 370 430 490 540 SVC008063 ORTHOPEDIC REHABILITATION 990 990 1290 1490 1680 1880 SVC008064 NEURO REHABILATATION 990 990 1290 1490 1680 1880 SVC008068 DOUBLE THERAPY ( ELECTROTHERAPY AND EXCERCISE ) 910 910 1190 1370 1550 1730 SVC008089 INPATIENT PHYSIOTHERAPY UPTO 20 MINUTES 550 550 720 830 940 1050 SVC008090 PHYSIOTHERAPY UPTO 40 MINUTES 990 990 1290 1490 1680 1880 SVC008091 PHYSIOTHERAPY UPTO 60 MINUTES (HANDS ON) 1320 1320 1720 1980 2240 2510 SVC008092 ADVANCED REHAB SESSION UPTO 60 MINUTES 1650 1650 2150 2480 2810 3140 SVC008093 EXERCISE TESTING (VO2 MAX AND FUNCTIONAL TEST) 1650 1650 2150 2480 2810 3140 SVC008094 EXERCISE TESTING (FUNCTIONAL TESTING) 990 990 1290 1490 1680 1880 SVC008095 CARDIAC REHABILITATION 610 610 790 910 1030 1150 SVC008096 PULMONARY REHABILITATION 610 610 790 910 1030 1150 SVC008098 SENIOR CITIZEN FITNESS PROGRAM(25 VISITS) 11000 11000 14300 16500 18700 20900 SVC008099 SENIOR CITIZEN FITNESS PROGRAM(GROUP SESSION FOR 25 DAYS) 2750 2750 3580 4130 4680 5230 SVC008100 PHYSIO-HOME VISIT 1320 1320 1720 1980 2240 2510 SVC008101 PHYSIO-HOME VISIT-10 VISITS 12100 12100 15730 18150 20570 22990 SVC008102 PHYSIOTHERAPY CONSULTATION 600 700 900 1000 1200 1300 Plastic Surgery SVC008130 BAGGY EYELIDS(BLEPHAROPLASTY )PER EYE 22000 28600 33000 37400 41800 SVC008132 CHIN AUGMENTATION 32230 41900 48350 54790 61240 SVC008133 MANAGEMENT OF CLOSED FRACTURE- NOSE 12100 15730 18150 20570 22990 SVC008135 COSMETIC CORRECTION OF DEFORMITIES OF LIP 17600 22880 26400 29920 33440 SVC008137 DERMAL FAT GRAFTING 16500 21450 24750 28050 31350 SVC008138 DERMABRASION - PART OF FACE 17600 22880 26400 29920 33440 SVC008139 RELEASE OF DUPUYTREN'S CONTRACTURE 8140 10580 12210 13840 15470 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008141 EXCISION OF CARBUNCLE 9240 12010 13860 15710 17560 SVC008142 FACIAL PARALYSIS - SLING 26070 33890 39110 44320 49530 SVC008144 FINGER TIP INJURY - FLAP 69300 90090 103950 117810 131670 SVC008145 FINGER TIP INJURY - REPAIR AND GRAFT 23100 30030 34650 39270 43890 SVC008146 FORE - HEAD RHINOPLASTY 31570 41040 47360 53670 59980 SVC008148 LIPECTOMY - COSMETIC 27500 35750 41250 46750 52250 SVC008150 OPEN REDUCTION OF MALAR FRACTURE 27500 35750 41250 46750 52250 SVC008151 MANDIBLE FRACTURE - CLOSED REDUCTION 24090 31320 36140 40950 45770 SVC008152 MANDIBLE FRACTURE - OPEN REDUCTION & PLATING 33000 42900 49500 56100 62700 SVC008153 REMOVAL OF MANDIBLE PLATE 19800 25740 29700 33660 37620 SVC008155 MAXILLARY FRACTURE (CMF SUSPENSION AND PLATING) 27500 35750 41250 46750 52250 SVC008156 OPEN REDUCTION INTERNAL FIXATION FRACTURE ZYGOMA 16500 21450 24750 28050 31350 SVC008157 REPAIR OF TORN EAR LOBULE 6660 8650 9980 11310 12640 SVC008158 PTOSIS-ERONTALIS SLING PROCEDURE (BILATERAL) 28820 37470 43230 48990 54760 SVC008159 PTOSIS-FRONTALIS SLING PROCEDURE (UNILATERAL) 19690 25600 29540 33470 37410 SVC008163 REVASCULARISATION OF LIMB 76670 99670 115010 130340 145670 SVC008164 RHINOPLASTY-COSMETIC 27500 35750 41250 46750 52250 SVC008165 SKIN GRAFTING - LARGE (GREATER THAN 20% OF TOTAL BOBY SURFACE AREA) 24200 31460 36300 41140 45980 SVC008166 SKIN GRAFTING - MEDIUM (8-20% OF TOTAL BOBY SURFACE AREA) 18700 24310 28050 31790 35530 SVC008167 SKIN GRAFTING - SMALL (LESS THAN 8% OF TOTAL BODY SURFACE AREA) 9350 12160 14030 15900 17770 SVC008170 MULTIPLE LACERATIONS (FACE) REPAIR 12540 16300 18810 21320 23830 SVC008171 EXCISION OF HAEMANGIOMA (LARGE) 40260 52340 60390 68440 76490 SVC008176 LACERATIONS (FACE) REPAIR- MODERATE 9450 12290 14180 16070 17960 SVC008181 LIPOSUCTION- BREAST REDUCTION MAMMOPLASTY-UNILERTERL 37400 48620 56100 63580 71060 SVC008182 ABDOMINAL- LIPOSUCTION 40700 52910 61050 69190 77330 SVC008183 FREE GRAFTS - VERY LARGE AREA 20% AND ABOVE 36300 47190 54450 61710 68970 SVC008184 SCAR REVISION-SMALL 13200 17160 19800 22440 25080 SVC008185 SCAR REVISION-LARGE 18700 24310 28050 31790 35530 SVC008187 FASCIOCUTANEOUS FLAP LARGE 73700 95810 110550 125290 140030 SVC008188 FASCIOCUTANEOUS FLAP SMALL 11000 14300 16500 18700 20900 SVC008193 DRAINAGE OF ABCESS 16720 21740 25080 28420 31770 SVC008196 COUNSELING FEE 1380 1380 1790 2060 2340 2610 SVC008204 Z-PLASTY 14630 19020 21950 24870 27800 SVC011907 FULL THICKNESS GRAFT - SMALL 7330 9520 10990 12450 13920 SVC011908 FULL THICKNESS GRAFT - MEDIUM 14650 19050 21980 24910 27840 SVC011909 FULL THICKNESS GRAFT - LARGE 21980 28570 32970 37360 41760 SVC011924 MAJOR VASCULAR SURGERY 36300 47190 54450 61710 68970 SVC011925 PALATAL FISTULA CLOSURE WITH TONGUE FLAP 25850 33610 38780 43950 49120 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite Pulmonology PKG007444 CONVEX PROBE- ENDOBRONCHIAL ULTRASOUND (DIAGNOSTIC) CP-EBUS+VIDEO BRONCHOSCOPE+ENDOBRONCHIAL33000 42900 49500 BIOPSY(56100 62700 SVC008225 FIBRE OPTIC BRONCHOSCOPY 9240 9240 12010 13860 15710 17560 SVC008226 PULMONARY FUNCTION TEST 1970 1970 2570 2960 3350 3750 SVC008227 SPIROMETRY WITH DIFFUSION STUDIES 2920 2920 3790 4370 4960 5540 SVC008228 SLEEP STUDY (POLYSOMNOGRAPHY) 12870 16730 19310 21880 24450 SVC008229 BRONCHOSCOPY WITH BIOPSY 7650 7650 9940 11470 13000 14530 SVC008230 BRONCHOSCOPY WITH TRANS BRONCHIAL NEEDLE ASPIRATION (TBNA) 12870 16730 19310 21880 24450 SVC008232 FIBREOPTIC BRONCHOSCOPIC INTUBATION 6440 8370 9650 10940 12230 SVC008235 FIBEROPTIC BRONCHOSCOPY + ENDOBRONCHIAL BIOPSY 6550 8510 9820 11130 12440 SVC008240 FIBEROPTIC BRONCHOSCOPY + BALOON DILATATION 16830 21880 25250 28610 31980 SVC008241 RIGID BRONCHOSCOPY + ENDOBRONCHIAL BIOPSY 17160 22310 25740 29170 32600 SVC008242 RIGID BRONCHOSCOPY + FOREIGN BODY REMOVAL 22660 29460 33990 38520 43050 SVC008243 RIGID BRONCHOSCOPY + TUMOUR DEBULKING (LASER) 25190 32750 37790 42820 47860 SVC008244 RIGID BRONCHOSCOPY + STENT PLACEMENT 25190 32750 37790 42820 47860 SVC008245 RIGID THORACOSCOPY 17160 22310 25740 29170 32600 SVC008246 RIGHT HEART CATHETERIZATION AND HEMODYNAMIC STUDY FOR PAH 25410 33030 38120 43200 48280 SVC008247 ESOPHAGEAL DOPPLER 3300 3300 4290 4950 5610 6270 SVC008248 6 MIN WALK TEST 230 230 300 350 390 440 SVC008249 EBUS-TBNA CHARGES 20210 20210 20210 20210 20210 20210 SVC008251 ASTHAMA EDUCATION 330 330 430 500 560 630 SVC008256 CPAP USAGE REPORT 550 550 720 830 940 1050 SVC008259 PHLEBOTOMY 1650 1650 2150 2480 2810 3140 SVC008260 PLEURAL BIOPSY 6160 6160 8010 9240 10470 11700 SVC008261 SLEEP STUDY 22550 29320 33830 38340 42850 SVC008262 USG GUIDED MASS LESION BIOPSY 8250 8250 10730 12380 14030 15680 SVC008265 VIDEO BRONCHOSCOPE 9610 9610 12500 14420 16340 18270 SVC008266 PFT WITH FRC 260 260 340 400 450 500 SVC008267 SPIROMETRY 990 990 1290 1490 1680 1880 SVC008268 WASHINGS/BRONCHOALVEOLAR LAVAGE (BAL) 810 810 1060 1220 1380 1550 SVC008269 BRUSHINGS 800 800 1100 1200 1400 1600 SVC008270 ENDOBRONCHIAL BIOPSY(EBB)/TRANSBRONCHIAL BIOPSY(TBB) 2660 3460 3990 4530 5060 SVC008271 CONVEX PROBE- ENDOBRONCHIAL ULTRASOUND (DIAGNOSTIC) CP-EBUS 31790 41330 47690 54040 60400 SVC008272 CONVEX PROBE-ENDOBRONCHIAL ULTRASOUND (STAGING) CP-EBUS 24200 31460 36300 41140 45980 SVC008273 RADIAL PROBE-ENDOBRONCHIAL ULTRASOUND (RP-EBUS) 14520 18880 21780 24680 27590 SVC008274 FOB RECANALIZATION (CRYORECANALIZATION/ELECTROCAUTERY/APC) 9680 12580 14520 16460 18390 SVC008275 THERAPEUTIC LAVAGE (SINGLE LUNG) 7920 10300 11880 13460 15050 SVC008276 FOB- BRONCHOPLEURAL FISTULA (BPF) CLOSURE (GLUE INSERTION/SPIGOT) 3630 4720 5450 6170 6900 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008277 SELF EXPANDING METALLIC STENT (SEMS) INSERTION 9680 12580 14520 16460 18390 SVC008278 BALLOON BRONCHOPLASTY 2420 3150 3630 4110 4600 SVC008281 SEMI-RIGID PLEUROSCOPY 14520 18880 21780 24680 27590 SVC008282 INDWELLING PLEURAL CATHETER (IPC) INSERTION 9680 12580 14520 16460 18390 SVC008283 ENDOBRONCHIAL NEEDLE ASPIRATION (EBNA) / TRANSBRONCHIAL NEEDLE ASPIRATION(TBNA)3080 4000 4620 5240 5850 SVC008284 FOB FOREIGN BODY REMOVAL 4840 6290 7260 8230 9200 SVC008285 RB STENT PLACEMENT (TRACHEAL/BRONCHIAL) 6050 7870 9080 10290 11500 SVC008287 PLEURODESIS_PULMONOLOGY 3630 4720 5450 6170 6900 SVC008288 BRONCHOSCOPIC SCREENING 2420 3150 3630 4110 4600 SVC008289 FENOMETRY 730 940 1090 1230 1380 SVC008292 BRONCHOSCOPY WITH APC/ELECTROCAUTERY (FOR HAEMOPTYSIS) 17380 22590 26070 29550 33020 SVC008295 BRONCHOSCOPIC INTUBATION 2970 3860 4460 5050 5640 SVC008296 MINI BAL (NON-BRONCHIAL LAVAGE) 1320 1720 1980 2240 2510 SVC008299 SPUTUM INDUCTION/ULTRASONIC NEBULIZERS 280 360 410 470 520 SVC008303 SLEEP STUDY (POLYSOMNOGRAPHY WITH TITRATION) 19950 25940 29930 33920 37910 SVC008304 MULTIPLE SLEEP LATENCY TEST 11000 14300 16500 18700 20900 SVC008305 SLEEP STUDY (PULSE OXIMETRY) 6600 8580 9900 11220 12540 SVC008306 PFT WITH REVERSIBILITY 1850 2780 2780 2780 2780 2780 SVC008308 STREPTOKINASE INSTILLATION IN PLEURAL CAVITY 1980 2570 2970 3370 3760 SVC008309 EBUS SCREENING 9860 12810 14780 16760 18730 Radiology PKG010379 CT ANGIOGRAPHY LIVER DONOR(PKG) 17350 22560 26030 29500 32970 SVC008317 CT ABDOMEN CONTRAST 8000 12000 12000 12000 12000 12000 SVC008318 CT ABDOMEN PLAIN 6000 9000 9000 9000 9000 9000 SVC008319 CT ABDOMEN UPPER PLAIN 5400 8100 8100 8100 8100 8100 SVC008321 CT ANGIOGRAPHY ABDOMEN 12600 18900 18900 18900 18900 18900 SVC008322 CT ANGIOGRAPHY LOWER LIMBS 12600 18900 18900 18900 18900 18900 SVC008324 CT ANGIOGRAPHY CHEST 10500 15750 15750 15750 15750 15750 SVC008325 CT ANGIOGRAPHY OF NECK VESSELS 8880 13320 13320 13320 13320 13320 SVC008326 CT ANGIOGRAPHY PULMONARY 8820 13230 13230 13230 13230 13230 SVC008327 CT ANGIOGRAPHY RENAL 8880 13320 13320 13320 13320 13320 SVC008328 CT ANGIOGRAPHY UPPER LIMB 12600 18900 18900 18900 18900 18900 SVC008329 CT AORTAGRAM 12000 18000 18000 18000 18000 18000 SVC008330 CT BRAIN WITH CONTRAST 4730 7100 7100 7100 7100 7100 SVC008331 CT CERVICAL SPINE 4800 7200 7200 7200 7200 7200 SVC008332 CT CERVICAL SPINE WITH CONTRAST 7140 10710 10710 10710 10710 10710 SVC008333 CT CHEST 4800 7200 7200 7200 7200 7200 SVC008334 CT CHEST CONTRAST 6800 10200 10200 10200 10200 10200 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008335 CT CONTRAST CHARGES - 100 ML 2100 3150 3150 3150 3150 3150 SVC008337 CT CONTRAST CHARGES - 50 ML 1050 1580 1580 1580 1580 1580 SVC008339 CT CV JUNCTION 5040 7560 7560 7560 7560 7560 SVC008341 CT DORSAL LUMBAR SPINE 6300 9450 9450 9450 9450 9450 SVC008342 CT DORSAL SPINE 5040 7560 7560 7560 7560 7560 SVC008343 CT DORSAL SPINE WITH CONTRAST 7140 10710 10710 10710 10710 10710 SVC008344 CT FACE 5040 7560 7560 7560 7560 7560 SVC008345 CT FACE WITH CONTRAST 7140 10710 10710 10710 10710 10710 SVC008347 CT GUIDED FNAC 6600 6600 8600 9900 11300 12600 SVC008350 CT HIP JOINT BOTH 4200 6300 6300 6300 6300 6300 SVC008351 CT HUMERUS RIGHT 4200 6300 6300 6300 6300 6300 SVC008352 CT KNEE LEFT 4200 6300 6300 6300 6300 6300 SVC008354 CT KNEE RIGHT 4200 6300 6300 6300 6300 6300 SVC008355 CT KUB CONTRAST 8400 12600 12600 12600 12600 12600 SVC008356 CT KUB PLAIN 6000 9000 9000 9000 9000 9000 SVC008357 CT LUMBOSACRAL SPINE 4800 7200 7200 7200 7200 7200 SVC008358 CT NECK 4200 6300 6300 6300 6300 6300 SVC008359 CT NECK CONTRAST 6300 9450 9450 9450 9450 9450 SVC008360 CT ORBITS 4200 6300 6300 6300 6300 6300 SVC008361 CT ORBITS CONTRAST 6300 9450 9450 9450 9450 9450 SVC008362 CT PETROUS TEMPORAL BONE 4200 6300 6300 6300 6300 6300 SVC008364 CT PNS 4200 6300 6300 6300 6300 6300 SVC008365 CT PNS CONTRAST 6300 9450 9450 9450 9450 9450 SVC008366 CT SACRO ILIAC JOINT 4200 6300 6300 6300 6300 6300 SVC008367 CT SCANOGRAM LOWER LIMBS (BOTH) 3150 4730 4730 4730 4730 4730 SVC008368 CT SHOULDER LEFT 4200 6300 6300 6300 6300 6300 SVC008369 CT SHOULDER RIGHT 4200 6300 6300 6300 6300 6300 SVC008371 CT THERAPEUTIC ASPIRATION 6300 9450 9450 9450 9450 9450 SVC008373 CT TRU CUT BIOPSY 6300 9450 9450 9450 9450 9450 SVC008374 CT TRU CUT BIOPSY WITH CONTRAST 10500 15750 15750 15750 15750 15750 SVC008375 CT WRIST PLAIN 4200 6300 6300 6300 6300 6300 SVC008376 DOPPLER ABDOMEN UPPER 3150 4730 4730 4730 4730 4730 SVC008377 DOPPLER AORTA 3150 4730 4730 4730 4730 4730 SVC008378 DOPPLER ARTERIAL LOWER LIMB BOTH 6000 9000 9000 9000 9000 9000 SVC008379 DOPPLER ARTERIAL LOWER LIMB SINGLE 3780 5670 5670 5670 5670 5670 SVC008380 DOPPLER ARTERIAL UPPER LIMB SINGLE 3780 5670 5670 5670 5670 5670 SVC008381 DOPPLER CAROTID BOTH 3600 5400 5400 5400 5400 5400 SVC008382 DOPPLER KIDNEY TRANSPLANT 3150 4730 4730 4730 4730 4730 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008384 DOPPLER PENILE 6300 9450 9450 9450 9450 9450 SVC008385 DOPPLER SCROTAL 3780 5670 5670 5670 5670 5670 SVC008386 DOPPLER SPLENO PORTAL 2100 3150 3150 3150 3150 3150 SVC008387 DOPPLER VENOUS LOWER LIMB BOTH 6000 9000 9000 9000 9000 9000 SVC008388 DOPPLER VENOUS LOWER LIMB SINGLE 3600 5400 5400 5400 5400 5400 SVC008389 DOPPLER VENOUS UPPER LIMB BOTH 6300 9450 9450 9450 9450 9450 SVC008390 DOPPLER VENOUS UPPER LIMB SINGLE 3780 5670 5670 5670 5670 5670 SVC008391 HR CT CHEST 4800 7200 7200 7200 7200 7200 SVC008393 MRI ABDOMEN WHOLE 11420 17130 17130 17130 17130 17130 SVC008394 MRI ABDOMEN WHOLE CONTRAST 12600 18900 18900 18900 18900 18900 SVC008395 MRI ANGIO ABDOMINAL CONTRAST 10500 15750 15750 15750 15750 15750 SVC008396 MRI ANGIOGRAPHY BRAIN 7550 11330 11330 11330 11330 11330 SVC008397 MRI ANGIOGRAPHY BRAIN WITH CONTRAST 8190 12290 12290 12290 12290 12290 SVC008398 MRI ANGIOGRAPHY NECK 7550 11330 11330 11330 11330 11330 SVC008399 MRI ANGIOGRAPHY NECK WITH CONTRAST 8190 12290 12290 12290 12290 12290 SVC008400 MRI ANGIOGRAPHY RENAL 7350 11030 11030 11030 11030 11030 SVC008401 MRI ANGIOGRAPHY RENAL WITH CONTRAST 10500 15750 15750 15750 15750 15750 SVC008402 MRI ANKLE JOINT LEFT 7350 11030 11030 11030 11030 11030 SVC008404 MRI ANKLE JOINT RIGHT 7350 11030 11030 11030 11030 11030 SVC008405 MRI ANKLE JOINT RIGHT CONTRAST 10500 15750 15750 15750 15750 15750 SVC008406 MRI BRACHIAL PLEXUS 7350 11030 11030 11030 11030 11030 SVC008407 MRI BRACHIAL PLEXUS CONTRAST 10500 15750 15750 15750 15750 15750 SVC008408 MRI BRAIN 7950 11930 11930 11930 11930 11930 SVC008409 MRI BRAIN CONTRAST 10500 15750 15750 15750 15750 15750 SVC008410 MRI BRAIN SCREENING 4800 7200 7200 7200 7200 7200 SVC008411 MRI BRAIN VENOGRAPHY 4200 6300 6300 6300 6300 6300 SVC008412 MRI BRAIN VENOGRAPHY WITH CONTRAST 7350 11030 11030 11030 11030 11030 SVC008413 MRI CERVICAL SPINE 8400 12600 12600 12600 12600 12600 SVC008414 MRI CERVICAL SPINE CONTRAST 10500 15750 15750 15750 15750 15750 SVC008415 MRI CERVICAL SPINE SCREENING 4800 7200 7200 7200 7200 7200 SVC008416 MRI CHEST 7350 11030 11030 11030 11030 11030 SVC008417 MRI CHEST CONTRAST 10500 15750 15750 15750 15750 15750 SVC008418 MRI CHOLANGIOGRAPHY (MRCP) 8400 12600 12600 12600 12600 12600 SVC008419 MRI CONTRAST CHARGES - 10 ML 3150 3150 4100 4730 5360 5990 SVC008420 MRI CONTRAST CHARGES - 20 ML 5250 5250 5250 5250 5250 5250 SVC008421 MRI DORSAL SPINE 8400 12600 12600 12600 12600 12600 SVC008422 MRI DORSAL SPINE CONTRAST 10500 15750 15750 15750 15750 15750 SVC008423 MRI DORSAL SPINE SCREENING 4800 7200 7200 7200 7200 7200 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008424 MRI ELBOW JOINT LEFT 7350 11030 11030 11030 11030 11030 SVC008426 MRI ELBOW JOINT RIGHT 7350 11030 11030 11030 11030 11030 SVC008428 MRI FOOT RIGHT 7350 11030 11030 11030 11030 11030 SVC008430 MRI GLUTEAL REGION 7350 11030 11030 11030 11030 11030 SVC008432 MRI HAND RIGHT 7350 11030 11030 11030 11030 11030 SVC008434 MRI HIP JOINT LEFT 7350 11030 11030 11030 11030 11030 SVC008435 MRI HIP JOINT LEFT CONTRAST 10500 15750 15750 15750 15750 15750 SVC008436 MRI HIP JOINT RIGHT 7350 11030 11030 11030 11030 11030 SVC008437 MRI HIP JOINT RIGHT CONTRAST 10500 15750 15750 15750 15750 15750 SVC008438 MRI HIP JOINTS BOTH 8400 12600 12600 12600 12600 12600 SVC008439 MRI KNEE LEFT 7950 11930 11930 11930 11930 11930 SVC008440 MRI KNEE LEFT CONTRAST 10500 15750 15750 15750 15750 15750 SVC008441 MRI KNEE RIGHT 7950 11930 11930 11930 11930 11930 SVC008442 MRI KNEE RIGHT CONTRAST 10500 15750 15750 15750 15750 15750 SVC008443 MRI LEG LEFT 7350 11030 11030 11030 11030 11030 SVC008444 MRI LEG LEFT CONTRAST 10500 15750 15750 15750 15750 15750 SVC008445 MRI LEG RIGHT 7350 11030 11030 11030 11030 11030 SVC008446 MRI LEG RIGHT CONTRAST 10500 15750 15750 15750 15750 15750 SVC008447 MRI LUMBAR SPINE 8400 12600 12600 12600 12600 12600 SVC008449 MRI LUMBOSACRAL SPINE 8000 12000 12000 12000 12000 12000 SVC008450 MRI LUMBOSACRAL SPINE CONTRAST 10500 15750 15750 15750 15750 15750 SVC008451 MRI LUMBOSACRAL SPINE SCREENING 5040 7560 7560 7560 7560 7560 SVC008452 MRI NASOPHARYNX 7350 11030 11030 11030 11030 11030 SVC008453 MRI NASOPHARYNX CONTRAST 10500 15750 15750 15750 15750 15750 SVC008454 MRI NECK 7350 11030 11030 11030 11030 11030 SVC008455 MRI NECK CONTRAST 10000 15000 15000 15000 15000 15000 SVC008456 MRI ORBIT CONTRAST 10500 15750 15750 15750 15750 15750 SVC008457 MRI ORBITS 7350 11030 11030 11030 11030 11030 SVC008458 MRI PELVIS 8000 12000 12000 12000 12000 12000 SVC008459 MRI PELVIS CONTRAST 10500 15750 15750 15750 15750 15750 SVC008460 MRI PROSTATE 7350 11030 11030 11030 11030 11030 SVC008461 MRI PROSTATE WITH CONTRAST 11550 17330 17330 17330 17330 17330 SVC008462 MRI REPORT SECOND OPINION 0 0 0 0 0 0 SVC008464 MRI SHOULDER JOINT LEFT 7350 11030 11030 11030 11030 11030 SVC008465 MRI SHOULDER JOINT LEFT CONTRAST 10500 15750 15750 15750 15750 15750 SVC008466 MRI SHOULDER JOINT RIGHT 7420 11130 11130 11130 11130 11130 SVC008467 MRI SHOULDER JOINT RIGHT CONTRAST 10500 15750 15750 15750 15750 15750 SVC008468 MRI SI JOINT 7350 11030 11030 11030 11030 11030 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008469 MRI SI JOINT CONTRAST 10500 15750 15750 15750 15750 15750 SVC008470 MRI SI JOINTS BOTH SCREENING 5040 7560 7560 7560 7560 7560 SVC008471 MRI SPECTROSCOPY 7000 10500 10500 10500 10500 10500 SVC008473 MRI SPINE SCREENING WHOLE 8000 12000 12000 12000 12000 12000 SVC008475 MRI TEMPOROMANDIBULAR JOINT 7350 11030 11030 11030 11030 11030 SVC008476 MRI TEMPOROMANDIBULAR JOINT WITH CONTRAST 10500 15750 15750 15750 15750 15750 SVC008477 MRI WRIST JOINT LEFT 7350 11030 11030 11030 11030 11030 SVC008478 MRI WRIST JOINT LEFT CONTRAST 10500 15750 15750 15750 15750 15750 SVC008479 MRI WRIST JOINT RIGHT 7350 11030 11030 11030 11030 11030 SVC008480 MRI WRIST JOINT RIGHT CONTRAST 10500 15750 15750 15750 15750 15750 SVC008481 USG ABDOMEN 1770 2660 2660 2660 2660 2660 SVC008482 USG ABDOMEN LOWER 1160 1740 1740 1740 1740 1740 SVC008483 USG ABDOMEN UPPER 1680 2520 2520 2520 2520 2520 SVC008485 USG ABDOMEN WHOLE 2100 3150 3150 3150 3150 3150 SVC008486 USG ABDOMEN WHOLE SCREENING 1770 2660 2660 2660 2660 2660 SVC008487 USG BIOPSY 6600 6600 8600 9900 11300 12600 SVC008489 USG BREAST BOTH 2000 3000 3000 3000 3000 3000 SVC008490 USG BREAST SINGLE 1160 1740 1740 1740 1740 1740 SVC008491 USG CHEST 1160 1740 1740 1740 1740 1740 SVC008492 USG DIAGNOSTIC ASPIRATION 3680 5520 5520 5520 5520 5520 SVC008493 USG FNAC 3680 3680 3680 3680 3680 3680 SVC008495 USG FOETAL WELL BEING 4200 6300 6300 6300 6300 6300 SVC008497 USG FOLLICULAR STUDY 3680 5520 5520 5520 5520 5520 SVC008501 USG GUIDED COMPRESSION THROMBOSIS OF PSEUDOANEURYSM 6830 10250 10250 10250 10250 10250 SVC008503 USG KIDNEY/RENAL 1160 1730 1730 1730 1730 1730 SVC008504 USG KUB 1400 2100 2100 2100 2100 2100 SVC008506 MAMMOGRAPHY BILATERAL 2790 4190 4190 4190 4190 4190 SVC008507 MAMMOGRAPHY UNILATERAL 1530 2300 2300 2300 2300 2300 SVC008508 USG NECK 1500 2250 2250 2250 2250 2250 SVC008509 USG PELVIS 1270 1910 1910 1910 1910 1910 SVC008510 USG PREGNANCY + DOPPLER & BPP 4200 6300 6300 6300 6300 6300 SVC008511 USG RESIDUAL URINE 320 480 480 480 480 480 SVC008512 USG SCROTUM 1470 2210 2210 2210 2210 2210 SVC008513 USG TESTIS 1470 2210 2210 2210 2210 2210 SVC008514 USG THYROID 1160 1740 1740 1740 1740 1740 SVC008515 USG TRANSRECTAL 1760 2650 2650 2650 2650 2650 SVC008516 USG TRU CUT BIOPSY 6300 9450 9450 9450 9450 9450 SVC008517 USG TRUS 1470 2210 2210 2210 2210 2210 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008518 USG TVS 2100 3150 3150 3150 3150 3150 SVC008519 USG UTERUS & ADNEXA 1160 1730 1730 1730 1730 1730 SVC008523 XRAY ABDOMEN ERECT 460 690 690 690 690 690 SVC008524 XRAY ABDOMEN SUPINE AP 460 690 690 690 690 690 SVC008525 MRI STERNO-CLAVICULAR REGION 7350 11030 11030 11030 11030 11030 SVC008526 XRAY ANKLE JOINT LEFT AP & LAT 640 960 960 960 960 960 SVC008527 XRAY ANKLE JOINT RIGHT AP 370 550 550 550 550 550 SVC008528 XRAY ANKLE JOINT RIGHT AP & LAT 640 960 960 960 960 960 SVC008529 XRAY ANKLE WITH LEG LEFT AP & LAT 560 840 840 840 840 840 SVC008530 XRAY ARM RIGHT AP 370 550 550 550 550 550 SVC008531 XRAY CERVICAL SPINE AP 460 690 690 690 690 690 SVC008532 XRAY CERVICAL SPINE AP & LAT 700 1050 1050 1050 1050 1050 SVC008533 XRAY CERVICAL SPINE LAT 460 690 690 690 690 690 SVC008534 XRAY CHEST APICAL 370 550 550 550 550 550 SVC008535 XRAY CHEST APICAL & LORDOTIC 560 830 830 830 830 830 SVC008536 XRAY CHEST BOTH LAT 560 830 830 830 830 830 SVC008537 XRAY CHEST LEFT LAT 370 550 550 550 550 550 SVC008538 XRAY CHEST PA 430 650 650 650 650 650 SVC008539 XRAY CHEST RIGHT LAT 370 560 560 560 560 560 SVC008540 XRAY CLAVICLE RIGHT AP 370 550 550 550 550 550 SVC008541 XRAY COCCYX AP & LAT 560 840 840 840 840 840 SVC008542 XRAY DORSAL SPINE AP 460 690 690 690 690 690 SVC008543 XRAY DORSAL SPINE AP & LAT 680 1020 1020 1020 1020 1020 SVC008544 XRAY DORSOLUMBAR SPINE AP & LAT 560 840 840 840 840 840 SVC008545 XRAY ELBOW LEFT AP & LAT 560 840 840 840 840 840 SVC008546 XRAY ELBOW RIGHT AP 370 550 550 550 550 550 SVC008547 XRAY ELBOW RIGHT AP & LAT 560 840 840 840 840 840 SVC008548 XRAY ELBOW RIGHT LAT 370 560 560 560 560 560 SVC008549 XRAY FEMUR LEFT AP 370 560 560 560 560 560 SVC008550 XRAY FEMUR LEFT AP & LAT 560 840 840 840 840 840 SVC008551 XRAY FEMUR RIGHT AP 370 550 550 550 550 550 SVC008552 XRAY FEMUR RIGHT AP & LAT 560 830 830 830 830 830 SVC008553 XRAY FOOT & ANKLE LEFT AP & LAT 560 830 830 830 830 830 SVC008554 XRAY FOOT & ANKLE RIGHT AP & LAT 560 840 840 840 840 840 SVC008555 XRAY FOOT LEFT AP 370 560 560 560 560 560 SVC008556 XRAY FOOT LEFT AP AND LAT 560 840 840 840 840 840 SVC008557 XRAY FOOT LEFT AP AND OBL 640 960 960 960 960 960 SVC008558 XRAY FOOT LEFT LAT 460 690 690 690 690 690 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008559 XRAY FOOT RIGHT AP 370 560 560 560 560 560 SVC008560 XRAY FOOT RIGHT AP AND OBL 680 1020 1020 1020 1020 1020 SVC008561 XRAY FOOT RIGHT AP & LAT 560 840 840 840 840 840 SVC008562 XRAY FOREARM LEFT AP & LAT 560 840 840 840 840 840 SVC008563 XRAY FOREARM RIGHT AP 370 560 560 560 560 560 SVC008564 XRAY FOREARM RIGHT AP & LAT 560 840 840 840 840 840 SVC008565 XRAY HAND & WRIST BOTH AP 560 840 840 840 840 840 SVC008566 XRAY HAND & WRIST BOTH AP & LAT 820 1230 1230 1230 1230 1230 SVC008567 XRAY HAND LEFT AP 370 550 550 550 550 550 SVC008568 XRAY HAND LEFT AP & LAT 560 840 840 840 840 840 SVC008569 XRAY HAND LEFT AP & OBLIQUE 560 840 840 840 840 840 SVC008570 XRAY HAND RIGHT AP 370 550 550 550 550 550 SVC008571 XRAY HAND RIGHT AP & OBLIQUE 560 840 840 840 840 840 SVC008572 XRAY HAND RIGHT AP & LAT 560 840 840 840 840 840 SVC008573 XRAY HANDS AP 450 680 680 680 680 680 SVC008574 XRAY HEEL LEFT AP 370 550 550 550 550 550 SVC008575 XRAY HEEL LEFT AP & LAT 560 840 840 840 840 840 SVC008576 XRAY HEEL LEFT LAT 370 560 560 560 560 560 SVC008577 XRAY HEEL RIGHT AP 370 550 550 550 550 550 SVC008578 XRAY HEEL RIGHT LAT 370 560 560 560 560 560 SVC008579 XRAY HEELS BOTH AP 560 830 830 830 830 830 SVC008580 XRAY HEELS BOTH LAT 560 840 840 840 840 840 SVC008581 XRAY HIP JOINT LEFT AP 460 690 690 690 690 690 SVC008582 XRAY HIP JOINT LEFT AP & LAT 680 1020 1020 1020 1020 1020 SVC008583 XRAY HIP JOINT LEFT LAT 370 560 560 560 560 560 SVC008584 XRAY HIP JOINT RIGHT AP 370 550 550 550 550 550 SVC008585 XRAY HIP JOINT RIGHT AP & LAT 680 1020 1020 1020 1020 1020 SVC008586 XRAY HIP JOINT RIGHT LAT 370 560 560 560 560 560 SVC008587 XRAY HSG 3260 4880 4880 4880 4880 4880 SVC008588 XRAY HUMERUS LEFT AP & LAT 560 840 840 840 840 840 SVC008589 XRAY HUMERUS RIGHT AP & LAT 560 840 840 840 840 840 SVC008590 XRAY IVP & IVU 4730 7100 7100 7100 7100 7100 SVC008591 XRAY KNEE (STANDING) LEFT AP & LAT 560 840 840 840 840 840 SVC008592 XRAY KNEE (STANDING) RIGHT AP & LAT 560 840 840 840 840 840 SVC008593 XRAY KNEE BOTH AP 560 830 830 830 830 830 SVC008594 XRAY KNEE BOTH AP & LAT 1100 1650 1650 1650 1650 1650 SVC008595 XRAY KNEE LEFT AP 370 550 550 550 550 550 SVC008596 XRAY KNEE LEFT AP & LAT 680 1020 1020 1020 1020 1020 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008597 XRAY KNEE LEFT LAT 370 560 560 560 560 560 SVC008598 XRAY KNEE RIGHT AP 450 680 680 680 680 680 SVC008599 XRAY KNEE RIGHT AP & LAT 680 1020 1020 1020 1020 1020 SVC008600 XRAY KNEE RIGHT LAT 460 690 690 690 690 690 SVC008601 XRAY KNEE SKYLINE 370 560 560 560 560 560 SVC008602 XRAY KNEES BOTH (STANDING) AP & LAT 920 1380 1380 1380 1380 1380 SVC008603 XRAY KNEES BOTH SKYLINE 560 840 840 840 840 840 SVC008604 XRAY KUB 370 560 560 560 560 560 SVC008605 XRAY LEG LEFT AP & LAT 680 1020 1020 1020 1020 1020 SVC008606 XRAY LEG RIGHT AP & LAT 680 1020 1020 1020 1020 1020 SVC008607 XRAY LEGS WITH ANKLE JOINT BOTH AP & LAT 820 1230 1230 1230 1230 1230 SVC008608 XRAY LUMBAR SPINE AP & LAT 680 1020 1020 1020 1020 1020 SVC008609 XRAY LUMBO SACRAL SPINE AP 460 690 690 690 690 690 SVC008610 XRAY LUMBO SACRAL SPINE AP & LAT 650 980 980 980 980 980 SVC008611 XRAY LUMBO SACRAL SPINE AP & LAT & OBLIQUE 820 1230 1230 1230 1230 1230 SVC008612 XRAY LUMBO SACRAL SPINE LAT 460 690 690 690 690 690 SVC008613 XRAY MANDIBLE 370 560 560 560 560 560 SVC008614 XRAY MANDABLE AP & LAT 560 830 830 830 830 830 SVC008615 XRAY NASAL BONE 370 560 560 560 560 560 SVC008616 XRAY NECK AP & LAT 560 830 830 830 830 830 SVC008617 XRAY NECK CERVICAL SPINE AP & LAT 560 830 830 830 830 830 SVC008618 XRAY NECK SOFT/TISSUE NASOPHARYNX 370 550 550 550 550 550 SVC008619 XRAY PELVIS AP 460 690 690 690 690 690 SVC008620 XRAY PELVIS HIPS BOTH AP 460 690 690 690 690 690 SVC008621 XRAY PNS 370 560 560 560 560 560 SVC008624 XRAY WRIST RIGHT AP, LAT & OBL 820 1230 1230 1230 1230 1230 SVC008625 XRAY SACRO ILIAC JOINTS BOTH OBLIQUE 560 830 830 830 830 830 SVC008626 XRAY SACRO-ILIAC JOINTS AP 370 550 550 550 550 550 SVC008628 XRAY SHOULDER LEFT AP 370 560 560 560 560 560 SVC008629 XRAY SHOULDER LEFT AP & AXILLARY 560 840 840 840 840 840 SVC008630 XRAY SHOULDER ONE SIDE AP/LAT 560 830 830 830 830 830 SVC008631 XRAY SHOULDER RIGHT AP 370 560 560 560 560 560 SVC008632 XRAY SHOULDER RIGHT AP & AXILLARY 560 840 840 840 840 840 SVC008633 XRAY SHOULDER RIGHT AP & LAT 560 840 840 840 840 840 SVC008634 XRAY SKULL AP 370 550 550 550 550 550 SVC008635 XRAY SKULL LAT 370 560 560 560 560 560 SVC008636 XRAY SKULL MASTOIDS TOWNES 370 550 550 550 550 550 SVC008638 XRAY T TUBE STUDIES 2020 3020 3020 3020 3020 3020 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008639 XRAY WRIST LEFT AP 370 550 550 550 550 550 SVC008640 XRAY WRIST LEFT AP & LAT 640 960 960 960 960 960 SVC008641 XRAY WRIST LEFT LAT 370 550 550 550 550 550 SVC008642 XRAY WRIST RIGHT AP 370 550 550 550 550 550 SVC008643 XRAY WRIST RIGHT AP & LAT 680 1020 1020 1020 1020 1020 SVC008644 XRAY WRIST RIGHT LAT 370 550 550 550 550 550 SVC008646 CT BRAIN PLAIN 3000 4500 4500 4500 4500 4500 SVC008647 DOPPLER RENAL 3000 4500 4500 4500 4500 4500 SVC008650 USG THERAPEUTIC ASPIRATION 5250 7880 7880 7880 7880 7880 SVC008651 XRAY FINGER AP & LAT 560 840 840 840 840 840 SVC008652 XRAY HAND SINGLE AP & LAT & OBLIQUE 820 1230 1230 1230 1230 1230 SVC008653 XRAY KNEES BOTH (STANDING) AP 560 830 830 830 830 830 SVC008654 XRAY MASTOIDS BOTH LAT & OBLIQUE 820 1230 1230 1230 1230 1230 SVC008655 XRAY NECK LAT 370 560 560 560 560 560 SVC008656 XRAY THIGH AP & LAT 680 1020 1020 1020 1020 1020 SVC008657 XRAY THORACIC SPINE AP & LAT 560 840 840 840 840 840 SVC008658 XRAY WRIST LEFT AP & LAT & OBLIQUE 820 1230 1230 1230 1230 1230 SVC008659 XRAY BARIUM ENEMA SINGLE CONTRAST 3150 4730 4730 4730 4730 4730 SVC008660 XRAY ABDOMEN ERECT AP & LAT 560 840 840 840 840 840 SVC008662 USG FOETAL WELL BEING - CONGENITAL ABNORMALITIES (LEVEL II) 5250 7880 7880 7880 7880 7880 SVC008664 CT PELVIS 4200 6300 6300 6300 6300 6300 SVC008665 DOPPLER ARTERIAL UPPER LIMB BOTH 6300 9450 9450 9450 9450 9450 SVC008666 XRAY SINGLE FILM 270 410 410 410 410 410 SVC008668 CT ABDOMEN & PELVIS CONTRAST 8400 12600 12600 12600 12600 12600 SVC008669 CT ABDOMEN & PELVIS PLAIN 6300 9450 9450 9450 9450 9450 SVC008670 CT ANGIOGRAPHY BRAIN (CEREBRAL ANGIOGRAPHY) 6300 9450 9450 9450 9450 9450 SVC008671 CT ANGIOGRAPHY CHEST & ABDOMEN 12600 18900 18900 18900 18900 18900 SVC008672 CT DOUBLE RULE OUT (CORONARY+AORTA) 14700 22050 22050 22050 22050 22050 SVC008673 CT TRIPLE RULE OUT (CORONARY + AORTA+ PULMONARY) 15750 23630 23630 23630 23630 23630 SVC008674 CT ANGIOGRAPHY HEPATIC 12000 18000 18000 18000 18000 18000 SVC008675 CT ANGIOGRAPHY OF CERVICAL & INTRACRANIAL VESSELS 10500 15750 15750 15750 15750 15750 SVC008676 CT ANGIOGRAPHY PERIPHERAL 12600 18900 18900 18900 18900 18900 SVC008677 CT ANKLE WITH FOOT 4200 6300 6300 6300 6300 6300 SVC008678 CT BRAIN & ORBIT CONTRAST 6300 9450 9450 9450 9450 9450 SVC008679 CT BRAIN & PNS CONTRAST 6300 9450 9450 9450 9450 9450 SVC008680 CT BRAIN & PNS PLAIN 4200 6300 6300 6300 6300 6300 SVC008681 CT BRAIN PERFUSION ANGIOGRAPHY 12600 18900 18900 18900 18900 18900 SVC008682 CT BRAIN PITUITARY 3150 4730 4730 4730 4730 4730 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008684 CT CARDIAC PEDIATRIC 10500 15750 15750 15750 15750 15750 SVC008685 CT CEREBRAL VENOGRAM CONTRAST 8400 12600 12600 12600 12600 12600 SVC008686 CT CERVICAL SPINE FLEXION EXTENSION 6300 9450 9450 9450 9450 9450 SVC008687 CT CERVICO DORSAL SPINE 6300 9450 9450 9450 9450 9450 SVC008688 CT PULMONARY ANGIOGRAPHY + DVT 14700 22050 22050 22050 22050 22050 SVC008689 CT CISTERNOGRAPHY 10500 15750 15750 15750 15750 15750 SVC008691 CT DIAGNOSTIC ASPIRATION 5250 7880 7880 7880 7880 7880 SVC008692 CT ELBOW BOTH 4200 6300 6300 6300 6300 6300 SVC008693 CT ELBOW LEFT 4200 6300 6300 6300 6300 6300 SVC008694 CT ELBOW RIGHT 4200 6300 6300 6300 6300 6300 SVC008695 CT FACE LOWER PLAIN 3150 4730 4730 4730 4730 4730 SVC008696 CT FACIAL BONES PLAIN 4200 6300 6300 6300 6300 6300 SVC008698 CT FEMUR RIGHT PLAIN 4200 6300 6300 6300 6300 6300 SVC008700 CT HEAD & NECK CONTRAST 7350 11030 11030 11030 11030 11030 SVC008701 CT HEAD & NECK PLAIN 5250 7880 7880 7880 7880 7880 SVC008702 CT HIP JOINT LEFT 4200 6300 6300 6300 6300 6300 SVC008703 CT HIP JOINT RIGHT 4200 6300 6300 6300 6300 6300 SVC008704 CT KIDNEYS DUAL PHASE CONTRAST 10500 15750 15750 15750 15750 15750 SVC008705 CT LUMBAR SPINE 4800 7200 7200 7200 7200 7200 SVC008707 CT NECK & THORAX CONTRAST 8400 12600 12600 12600 12600 12600 SVC008708 CT NECK & THORAX PLAIN 6300 9450 9450 9450 9450 9450 SVC008709 CT PELVIS WITH HIP JOINTS 5040 7560 7560 7560 7560 7560 SVC008713 CT SCANOGRAM 1890 2840 2840 2840 2840 2840 SVC008714 CT SKULL BASE 4200 6300 6300 6300 6300 6300 SVC008715 CT SPINE LIMITED 4200 6300 6300 6300 6300 6300 SVC008716 CT SPINE TWO REGIONS 8400 12600 12600 12600 12600 12600 SVC008719 CT THORAX + ABDOMEN + PELVIS CONTRAST 10500 15750 15750 15750 15750 15750 SVC008720 CT THORAX + ABDOMEN + PELVIS PLAIN 8400 12600 12600 12600 12600 12600 SVC008721 CT THORAX CONTRAST 7140 10710 10710 10710 10710 10710 SVC008722 CT THORAX PLAIN 5040 7560 7560 7560 7560 7560 SVC008724 CT TRANSPLANT KIDNEY 8400 12600 12600 12600 12600 12600 SVC008725 MRI ABDOMEN & PELVIS CONTRAST 16800 25200 25200 25200 25200 25200 SVC008726 MRI ABDOMEN LIMITED STUDY PLAIN 5250 7880 7880 7880 7880 7880 SVC008727 MRI ABDOMEN UPPER CONTRAST 10500 15750 15750 15750 15750 15750 SVC008731 MRI ANGIO CERVICAL CAROTID ARTERIES PLAIN 7350 11030 11030 11030 11030 11030 SVC008733 MRI ANGIO ONE REGION 7350 11030 11030 11030 11030 11030 SVC008737 MRI ANGIOGRAM PERIPHERAL CONTRAST 12600 18900 18900 18900 18900 18900 SVC008738 MRI ANGIOGRAM PERIPHERAL PLAIN 9450 14180 14180 14180 14180 14180 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008739 MRI ARM HUMERUS LEFT 7350 11030 11030 11030 11030 11030 SVC008740 MRI ARM HUMERUS RIGHT 7350 11030 11030 11030 11030 11030 SVC008743 MRI BREAST 7350 11030 11030 11030 11030 11030 SVC008744 MRI BREAST CONTRAST 11550 17330 17330 17330 17330 17330 SVC008745 MRI CARDIAC MORPHOLOGY 8400 12600 12600 12600 12600 12600 SVC008749 MRI CV JUNCTION 8400 12600 12600 12600 12600 12600 SVC008751 MRI DTI DIFFUSION TENSOR IMAGING 5250 7880 7880 7880 7880 7880 SVC008752 MRI FEMUR RIGHT 7350 11030 11030 11030 11030 11030 SVC008753 MRI FEMUR RIGHT WITH CONTRAST 10500 15750 15750 15750 15750 15750 SVC008754 MRI FOETAL STUDY 7350 11030 11030 11030 11030 11030 SVC008755 MRI FOREARM RIGHT WITH CONTRAST 10500 15750 15750 15750 15750 15750 SVC008756 MRI FOREARM LEFT 7350 11030 11030 11030 11030 11030 SVC008757 MRI FOREARM RIGHT 7350 11030 11030 11030 11030 11030 SVC008761 MRI LIVER DYNAMIC CONTRAST 12600 18900 18900 18900 18900 18900 SVC008762 MRI LUMBAR SPINE CONTRAST 10500 15750 15750 15750 15750 15750 SVC008763 MRI MS PROTOCOL WITH CONTRAST 10500 15750 15750 15750 15750 15750 SVC008764 MRI MYELOGRAPHY 3150 4730 4730 4730 4730 4730 SVC008769 MRI ONE REGION 7350 11030 11030 11030 11030 11030 SVC008770 MRI PELVIS WITH CONTRAST 10500 15750 15750 15750 15750 15750 SVC008771 MRI PERFUSION 5250 7880 7880 7880 7880 7880 SVC008772 MRI PERFUSION + DIFFUSION TENSOR IMAGING (DTI) 10500 15750 15750 15750 15750 15750 SVC008773 MRI PITUITARY 8000 12000 12000 12000 12000 12000 SVC008774 MRI PNS 7350 11030 11030 11030 11030 11030 SVC008776 MRI SEDATION CHARGES 4200 6300 6300 6300 6300 6300 SVC008779 MRI T1 PRE & POST CONTRAST SINGLE SEQUENCE 5250 5250 5250 5250 5250 5250 SVC008781 MRI UROGRAPHY (MRU) 8820 13230 13230 13230 13230 13230 SVC008782 MRI VENOGRAM 7350 11030 11030 11030 11030 11030 SVC008783 MRI VENOGRAPHY THORAX / ABDOMEN 7350 11030 11030 11030 11030 11030 SVC008784 MRI WHOLE BODY SCREENING 7350 11030 11030 11030 11030 11030 SVC008786 USG A V FISTULA MAPPING SINGLE LIMB 3150 4730 4730 4730 4730 4730 SVC008787 USG ABDOMEN & PELVIS 2100 3150 3150 3150 3150 3150 SVC008788 USG ABDOMEN LOWER SCREENING 1160 1740 1740 1740 1740 1740 SVC008790 USG BLADDER 1160 1730 1730 1730 1730 1730 SVC008791 USG CHEST SCREENING 1160 1730 1730 1730 1730 1730 SVC008792 USG EARLY PREGNANCY (12W) 2100 3150 3150 3150 3150 3150 SVC008793 USG EYEBALL/ORBIT 1160 1730 1730 1730 1730 1730 SVC008795 USG FOLLOW UP OVULATION 560 830 830 830 830 830 SVC008796 USG FOR TRANSPLANT KIDNEY 2100 3150 3150 3150 3150 3150 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008797 USG HEAD CRANIUM 1470 2210 2210 2210 2210 2210 SVC008798 USG JOINT SINGLE 1470 2210 2210 2210 2210 2210 SVC008800 USG MAMMOGRAPHY + MAMMOSONOGRAPHY BILATERAL 2100 3150 3150 3150 3150 3150 SVC008803 USG MUSCULOSKELETAL 1470 2210 2210 2210 2210 2210 SVC008804 USG NEUROSONOGRAM 1470 2210 2210 2210 2210 2210 SVC008806 USG PAROTID 1160 1740 1740 1740 1740 1740 SVC008807 USG TVS (PELVIS) 2100 3150 3150 3150 3150 3150 SVC008809 USG PREGNANCY (ANOMALY SCAN) 4200 6300 6300 6300 6300 6300 SVC008810 USG PROSTATE 1770 2660 2660 2660 2660 2660 SVC008811 USG SINGLE ORGAN 1390 2090 2090 2090 2090 2090 SVC008812 USG SINGLE ORGAN SCREENING 740 1110 1110 1110 1110 1110 SVC008813 USG THIGH 1120 1690 1690 1690 1690 1690 SVC008815 USG WHOLE ABDOMEN SCREENING 1390 2080 2080 2080 2080 2080 SVC008818 XRAY ANKLE BOTH JOINTS AP 560 830 830 830 830 830 SVC008819 XRAY ANKLE BOTH JOINTS AP & LAT 820 1230 1230 1230 1230 1230 SVC008820 XRAY ANKLE BOTH JOINTS LAT 560 840 840 840 840 840 SVC008821 XRAY ANKLE JOINT LEFT AP 370 560 560 560 560 560 SVC008822 XRAY ANKLE JOINT LEFT LAT 370 560 560 560 560 560 SVC008823 XRAY ANKLE JOINT RIGHT LAT 370 560 560 560 560 560 SVC008824 XRAY ANKLE WITH LEG RIGHT AP & LAT 680 1020 1020 1020 1020 1020 SVC008825 XRAY ARM BOTH AP 560 830 830 830 830 830 SVC008826 XRAY ARM BOTH AP & LAT 820 1230 1230 1230 1230 1230 SVC008828 XRAY ARM LEFT AP 370 550 550 550 550 550 SVC008829 XRAY ARM LEFT AP & LAT 560 840 840 840 840 840 SVC008830 XRAY ARM LEFT LAT 370 550 550 550 550 550 SVC008831 XRAY ARM RIGHT AP & LAT 560 830 830 830 830 830 SVC008832 XRAY ARM RIGHT LAT 370 550 550 550 550 550 SVC008833 XRAY BARIUM ENEMA DOUBLE CONTRAST 4200 6300 6300 6300 6300 6300 SVC008834 XRAY BARIUM IC JUNCTION 3150 4730 4730 4730 4730 4730 SVC008835 XRAY BARIUM MEAL DOUBLE CONTRAST 3150 4730 4730 4730 4730 4730 SVC008836 XRAY BARIUM MEAL FOLLOW THROUGH BMFT 4200 6300 6300 6300 6300 6300 SVC008837 XRAY BARIUM MEAL SINGLE CONTRAST 3150 4730 4730 4730 4730 4730 SVC008838 XRAY BARIUM SWALLOW 2630 3950 3950 3950 3950 3950 SVC008839 XRAY BREAST MAMMOGRAPHY BOTH 2100 3150 3150 3150 3150 3150 SVC008840 XRAY BREAST MAMMOGRAPHY SINGLE 1050 1580 1580 1580 1580 1580 SVC008841 XRAY CALCANEUM BOTH LAT & AXIAL 820 1230 1230 1230 1230 1230 SVC008842 XRAY CALCANEUM LEFT LAT & AXIAL 560 830 830 830 830 830 SVC008843 XRAY CALCANEUM RIGHT LAT & AXIAL 560 830 830 830 830 830 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008844 XRAY CERVICAL SPINE OBLIQUE 560 830 830 830 830 830 SVC008845 XRAY CHEST FOR RIBS 370 550 550 550 550 550 SVC008846 XRAY CHEST LEFT OBLIQUE 370 550 550 550 550 550 SVC008847 XRAY CHEST OBLIQUE BOTH 560 840 840 840 840 840 SVC008848 XRAY CHEST PA & LAT 560 840 840 840 840 840 SVC008849 XRAY CHEST RIGHT OBLIQUE 370 550 550 550 550 550 SVC008850 XRAY CLAVICLE BOTH AP 560 830 830 830 830 830 SVC008851 XRAY CLAVICLE LEFT AP 370 560 560 560 560 560 SVC008852 XRAY COCCYX AP 370 550 550 550 550 550 SVC008853 XRAY COCCYX LAT 370 550 550 550 550 550 SVC008855 XRAY CERVICAL SPINE FLE & EXT 680 1020 1020 1020 1020 1020 SVC008857 XRAY DORSAL SPINE LAT 460 690 690 690 690 690 SVC008858 XRAY DORSOLUMBAR SPINE AP 370 550 550 550 550 550 SVC008859 XRAY DORSOLUMBAR SPINE LAT 370 550 550 550 550 550 SVC008860 XRAY ELBOW BOTH AP & LAT 820 1230 1230 1230 1230 1230 SVC008861 XRAY ELBOW BOTH LAT 560 840 840 840 840 840 SVC008862 XRAY ELBOW LEFT AP 370 560 560 560 560 560 SVC008863 XRAY ELBOW LEFT LAT 370 560 560 560 560 560 SVC008864 XRAY ERCP 1680 2520 2520 2520 2520 2520 SVC008865 XRAY FEET BOTH (STANDING) LAT 560 840 840 840 840 840 SVC008866 XRAY FEET BOTH AP 560 840 840 840 840 840 SVC008867 XRAY FEET BOTH AP & LAT 820 1230 1230 1230 1230 1230 SVC008868 XRAY FEET BOTH AP & OBLIQUE 820 1230 1230 1230 1230 1230 SVC008869 XRAY FEET BOTH LAT 560 830 830 830 830 830 SVC008871 XRAY FEMUR BOTH AP & LAT 970 1450 1450 1450 1450 1450 SVC008872 XRAY FEMUR LEFT LAT 370 550 550 550 550 550 SVC008873 XRAY FEMUR RIGHT LAT 370 550 550 550 550 550 SVC008874 XRAY FISTULOGRAM 1680 2520 2520 2520 2520 2520 SVC008875 XRAY FLUROSCOPY CHEST 370 560 560 560 560 560 SVC008876 XRAY FOOT RIGHT LAT 370 560 560 560 560 560 SVC008877 XRAY FOOT STANDING LAT 370 560 560 560 560 560 SVC008878 XRAY FOREARM BOTH AP & LAT 820 1230 1230 1230 1230 1230 SVC008879 XRAY FOREARM LEFT AP 370 550 550 550 550 550 SVC008880 XRAY FOREARM LEFT LAT 370 550 550 550 550 550 SVC008881 XRAY FOREARM RIGHT LAT 370 550 550 550 550 550 SVC008882 XRAY FOREARM WRIST AP & LAT 560 840 840 840 840 840 SVC008883 XRAY HAND & WRIST BOTH LAT 560 830 830 830 830 830 SVC008884 XRAY HAND LEFT LAT 370 550 550 550 550 550 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008885 XRAY HAND RIGHT LAT 370 560 560 560 560 560 SVC008886 XRAY HANDS BOTH AP 560 840 840 840 840 840 SVC008887 XRAY HANDS BOTH AP & OBLIQUE 820 1230 1230 1230 1230 1230 SVC008890 XRAY HIP JOINTS BOTH AP 680 1020 1020 1020 1020 1020 SVC008891 XRAY HIP JOINTS BOTH AP & LAT 820 1230 1230 1230 1230 1230 SVC008892 XRAY HIP LEFT AP & LAT 560 830 830 830 830 830 SVC008893 XRAY HIP RIGHT AP 450 680 680 680 680 680 SVC008894 XRAY HIP RIGHT AP & LAT 680 1020 1020 1020 1020 1020 SVC008895 XRAY HIP RIGHT LAT 370 550 550 550 550 550 SVC008896 XRAY HIP WITH PROXIMAL FEMUR LEFT AP 370 550 550 550 550 550 SVC008897 XRAY HIP WITH PROXIMAL FEMUR RIGHT AP 370 550 550 550 550 550 SVC008898 XRAY HUMERUS AP 460 690 690 690 690 690 SVC008899 XRAY HUMERUS LAT 370 560 560 560 560 560 SVC008900 XRAY IMAGE GUIDED PROCEDURE FLURO 2100 3150 3150 3150 3150 3150 SVC008901 XRAY INDEX FINGER RIGHT AP & LAT 560 830 830 830 830 830 SVC008902 XRAY INDEX FINGER RIGHT LAT 370 550 550 550 550 550 SVC008903 XRAY KNEES BOTH (STANDING) AP & LAT & SKYLINE 980 1470 1470 1470 1470 1470 SVC008904 XRAY KNEE BOTH LAT 560 840 840 840 840 840 SVC008905 XRAY KNEE BOTH OBLIQUES 560 830 830 830 830 830 SVC008906 XRAY LEG ANKLE AP & LAT 560 830 830 830 830 830 SVC008907 XRAY LEG LEFT AP 370 560 560 560 560 560 SVC008908 XRAY LEG LEFT LAT 370 550 550 550 550 550 SVC008909 XRAY LOWER LEG AP & LAT 560 830 830 830 830 830 SVC008910 XRAY LEG RIGHT AP 370 550 550 550 550 550 SVC008911 XRAY LEG RIGHT LAT 370 550 550 550 550 550 SVC008912 XRAY LEG WITH ANKLE JOINT LEFT AP & LAT 560 840 840 840 840 840 SVC008913 XRAY LEG WITH ANKLE JOINT RIGHT AP & LAT 560 840 840 840 840 840 SVC008914 XRAY LEG WITH KNEE JOINT LEFT AP & LAT 560 840 840 840 840 840 SVC008915 XRAY LEG WITH KNEE JOINT RIGHT AP & LAT 560 840 840 840 840 840 SVC008916 XRAY LEGS BOTH AP & LAT 820 1230 1230 1230 1230 1230 SVC008917 XRAY LEGS WITH KNEE JOINT BOTH AP & LAT 820 1230 1230 1230 1230 1230 SVC008919 XRAY LOWER LIMBS BOTH AP 560 830 830 830 830 830 SVC008920 XRAY LUMBAR SPINE AP 460 690 690 690 690 690 SVC008921 XRAY LUMBAR SPINE LAT 460 690 690 690 690 690 SVC008922 XRAY LUMBO SACRAL SPINE OBLIQUE 370 560 560 560 560 560 SVC008923 XRAY MASTOIDS BOTH 560 830 830 830 830 830 SVC008924 XRAY MICTURATING CYSTOURE THROGRAM MCU 2100 3150 3150 3150 3150 3150 SVC008925 XRAY MIDDLE FINGER AP & LAT 560 830 830 830 830 830 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008926 XRAY NECK CERVICAL SPINE AP 370 550 550 550 550 550 SVC008927 XRAY NECK CERVICAL SPINE AP & FLEXION & EXTENSION 820 1230 1230 1230 1230 1230 SVC008930 XRAY NECK CERVICAL SPINE FLEXION & EXTENSION 560 830 830 830 830 830 SVC008931 XRAY NECK CERVICAL SPINE LAT 370 550 550 550 550 550 SVC008934 XRAY NECK NASOPHARYNX LAT 370 550 550 550 550 550 SVC008937 XRAY ORBIT AP & LAT 560 830 830 830 830 830 SVC008938 XRAY ORBITS 370 550 550 550 550 550 SVC008941 XRAY SACRO COCCYGEAL JUNCTION AP & LAT 560 830 830 830 830 830 SVC008942 XRAY SACRO ILIAC JOINT LEFT OBL 370 550 550 550 550 550 SVC008943 XRAY SACRO ILIAC JOINT PA 560 840 840 840 840 840 SVC008944 XRAY SACRO ILIAC JOINT BOTH PA & OBLIQUE 820 1230 1230 1230 1230 1230 SVC008945 XRAY SACRO ILIAC JOINT PA & AP & OBLIQUE 820 1230 1230 1230 1230 1230 SVC008946 XRAY SACRO ILIAC JOINT RIGHT OBLIQUE 370 550 550 550 550 550 SVC008947 XRAY SCAPHOID VIEWS 560 830 830 830 830 830 SVC008950 XRAY SCAPULA BOTH AP & LAT 820 1230 1230 1230 1230 1230 SVC008952 XRAY SCAPULA LEFT AP 370 550 550 550 550 550 SVC008953 XRAY SCAPULA LEFT LAT 370 550 550 550 550 550 SVC008954 XRAY SCAPULA RIGHT AP 370 550 550 550 550 550 SVC008955 XRAY SCAPULA RIGHT LAT 370 550 550 550 550 550 SVC008956 XRAY SHOULDER BOTH AP 560 840 840 840 840 840 SVC008957 XRAY SHOULDER BOTH AP & AXILLARY 820 1230 1230 1230 1230 1230 SVC008958 XRAY SHOULDER BOTH AP & LAT 820 1230 1230 1230 1230 1230 SVC008959 XRAY SHOULDER BOTH LAT 560 830 830 830 830 830 SVC008960 XRAY SHOULDER LEFT AP & LAT 560 840 840 840 840 840 SVC008961 XRAY SHOULDER LEFT LAT 370 560 560 560 560 560 SVC008962 XRAY SHOULDER RIGHT LAT 370 560 560 560 560 560 SVC008963 XRAY SIALOGRAM 1680 2520 2520 2520 2520 2520 SVC008964 XRAY SINOGRAM 1680 2520 2520 2520 2520 2520 SVC008966 XRAY SKULL AP & LAT 680 1020 1020 1020 1020 1020 SVC008967 XRAY SKULL BASE 370 550 550 550 550 550 SVC008968 XRAY SKULL BOTH MANDIBLE AP & LAT & OBLIQUE 1020 1530 1530 1530 1530 1530 SVC008969 XRAY SKULL BOTH MASTOIDS LAT OBL 560 830 830 830 830 830 SVC008970 XRAY BOTH TEMPORO MANDIBULAR JOINT CLOSE MOUTH 560 830 830 830 830 830 SVC008972 XRAY SKULL MANDIBLE AP 370 550 550 550 550 550 SVC008974 XRAY SKULL NASAL BONE LAT 370 550 550 550 550 550 SVC008975 XRAY SKULL ORBITS AP 370 550 550 550 550 550 SVC008976 XRAY SKULL PNS 370 550 550 550 550 550 SVC008978 XRAY SKULL AP OR LAT 370 550 550 550 550 550 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC008979 XRAY SKULL TOWNES VIEW 370 550 550 550 550 550 SVC008980 XRAY SKYLINE VIEW OF PATELLA 370 550 550 550 550 550 SVC008981 XRAY STERNUM AP & LAT 560 830 830 830 830 830 SVC008986 XRAY TEMPORO MANDIBULAR JOINT OPEN MOUTH 370 550 550 550 550 550 SVC008989 XRAY CERVICOTHORACIC SPINE AP & LAT 560 830 830 830 830 830 SVC008991 XRAY THUMB SINGLE AP & LAT 560 840 840 840 840 840 SVC008992 XRAY TIBIA 370 550 550 550 550 550 SVC008994 XRAY TIBIA LEFT AP & LAT 560 830 830 830 830 830 SVC008995 XRAY TIBIA BOTH AP & LAT 820 1230 1230 1230 1230 1230 SVC008996 XRAY TIBIA RIGHT AP & LAT 560 830 830 830 830 830 SVC008997 XRAY TIBIA WITH KNEE & ANKLE LEFT AP & LAT 560 830 830 830 830 830 SVC008998 XRAY TIBIA WITH KNEE & ANKLE RIGHT AP & LAT 560 830 830 830 830 830 SVC008999 XRAY TOE BIG AP & LAT 560 830 830 830 830 830 SVC009000 XRAY VIDEO FLUROSCOPY 1030 1540 1540 1540 1540 1540 SVC009001 XRAY WRIST BOTH AP & LAT 970 1460 1460 1460 1460 1460 SVC009003 XRAY WRIST LEFT AP & SCAPHOID 560 830 830 830 830 830 SVC009004 XRAY WRIST LEFT SCAPHOID 370 550 550 550 550 550 SVC009005 XRAY WRIST RIGHT AP & SCAPHOID 560 830 830 830 830 830 SVC009006 XRAY WRIST RIGHT SCAPHOID 370 560 560 560 560 560 SVC009007 MRI CD CHARGES 300 300 300 300 300 300 SVC009008 USG FILM 250 380 380 380 380 380 SVC009009 USG GUIDED ABSCESS DRAINAGE 5500 5500 7200 8300 9400 10500 SVC009011 USG GUIDED LIVER BIOPSY 9450 9450 9450 9450 9450 SVC009012 USG GUIDED PIGTAIL 9450 9450 9450 9450 9450 SVC009015 HRCT CHEST WITH CONTRAST 6300 9450 9450 9450 9450 9450 SVC009016 CT CD CHARGES 300 300 300 300 300 300 SVC009017 CT FILM 300 450 450 450 450 450 SVC009020 CT GUIDED BIOPSY 7350 7350 7350 7350 7350 7350 SVC009022 CT GUIDED PIGTAIL 7700 7700 10100 11600 13100 14700 SVC009023 CHEMOEMBOLISATION 27410 27410 27410 27410 27410 SVC009024 ERCP - CHECK CHOLANGIOGRAM 18270 18270 18270 18270 18270 SVC009025 PERCUTANEOUS TRANS HEPATIC BILIARY DRAINGE (PTBD) 35600 35600 35600 35600 35600 SVC009026 UTERINE ARTERY EMBOLIZATION 35170 35170 35170 35170 35170 SVC009027 CT REPORTING 0 0 0 0 0 0 SVC009030 GUIDANCE FOR BIOPSY INTRA - OPERATIVE 7880 7880 7880 7880 7880 SVC009031 IVC - INFERIOR VENACAVAL ANGIOGRAM 14810 14810 14810 14810 14810 SVC009032 DOPPLER HEPATIC (LIVER) 4100 6150 6150 6150 6150 6150 SVC009033 DOPPLER ILIAC VESSEL 3150 4730 4730 4730 4730 4730 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC009037 USG PREGNANCY DOPPLER 3150 4730 4730 4730 4730 4730 SVC009040 DOPPLER VARICOSE VEINS LOWER LIMB SINGLE 3150 4730 4730 4730 4730 4730 SVC009041 FLUOROSCOPY GUIDED PROCEDURE 2420 3620 3620 3620 3620 3620 SVC009043 TRANSRECTAL BIOPSY 8680 13030 13030 13030 13030 13030 SVC009044 CT THORAX AND ABDOMEN PLAIN 10500 15750 15750 15750 15750 15750 SVC009045 CT ABDOMEN LOWER CONTRAST 6300 9450 9450 9450 9450 9450 SVC009099 VERIFICATION CHARGE CONE BEAM CT 14070 21110 21110 21110 21110 21110 SVC009100 VERIFICATION CHARGE EPID 7070 10600 10600 10600 10600 10600 SVC009107 CT ABDOMEN WITH CONTRAST 8400 12600 12600 12600 12600 12600 SVC009108 XRAY LUMBO SACRAL SPINE EXTENSION & FLEXION 750 1130 1130 1130 1130 1130 SVC009109 FLUOROSCOPY 670 1010 1010 1010 1010 1010 SVC009113 RETROGRADE URETHROGRAPHY (RGU) 3150 4730 4730 4730 4730 4730 SVC009114 MRI ANGIOGRAPHY HEAD AND NECK (TOF) 8400 12600 12600 12600 12600 12600 SVC009115 CT LEG RIGHT 4200 6300 6300 6300 6300 6300 SVC009116 CT LEG LEFT 4200 6300 6300 6300 6300 6300 SVC009118 USG TRANSVAGINAL 1470 2210 2210 2210 2210 2210 SVC009121 XRAY HANDS BOTH AP & LAT 820 1230 1230 1230 1230 1230 SVC009127 GASTROGRAPHIN SWALLOW 2840 4250 4250 4250 4250 4250 SVC009135 BRONCHIAL BRUSH SMEAR FOR CYTOLOGY 5110 7670 7670 7670 7670 7670 SVC009136 CAPD CATHETER REMOVAL 5010 7510 7510 7510 7510 7510 SVC009137 CARDIOTOCOGRAPHY 560 830 830 830 830 830 SVC009138 COLONOSCOPY WITH BIOPSY 36430 36430 36430 36430 36430 SVC009145 MR STROKE PROTOCOL (CATEGORY 2 ) 14700 22050 22050 22050 22050 22050 SVC009148 MR STROKE PROTOCOL (CATEGORY 1) 9000 13500 13500 13500 13500 13500 SVC009149 MRI FILM 350 530 530 530 530 530 SVC009155 CT PELVIS CONTRAST 6300 9450 9450 9450 9450 9450 SVC009163 USG EYEBALL/ORBIT(BOTH) 1470 2210 2210 2210 2210 2210 SVC009164 USG SHOULDER (SINGLE) 2100 3150 3150 3150 3150 3150 SVC009172 BIOPHYSICAL PROFILE(BPP) 1750 2630 2630 2630 2630 2630 SVC009173 USG PENIS 2100 3150 3150 3150 3150 3150 SVC009184 CT ABDOMEN LOWER PLAIN 4200 6300 6300 6300 6300 6300 SVC009187 BONE DENSITOMETRY - SINGLE SITE 2910 4360 4360 4360 4360 4360 SVC009188 BONE DENSITOMETRY - BOTH SITES 2520 3780 3780 3780 3780 3780 SVC009189 BONE DENSITOMETRY - BOTH SITES (SPINE, HIP & EXTREMITY) 3150 4730 4730 4730 4730 4730 SVC009190 BONE DENSITOMETRY- WHOLE BODY 3570 5360 5360 5360 5360 5360 SVC009193 CD CHARGES 300 450 450 450 450 450 SVC009194 MRI SCREENING 4800 7200 7200 7200 7200 7200 SVC009196 MRI BRAIN CSF FLOW STUDY 3150 4730 4730 4730 4730 4730 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC009210 CT IVP 6300 9450 9450 9450 9450 9450 SVC009213 MRI CISTERNOGRAPHY 7350 11030 11030 11030 11030 11030 SVC009215 CT GUIDED PERCUTANEOUS NEPHROSTOMY 7700 7700 10100 11600 13100 14700 SVC009216 CT UROGRAPHY 8400 12600 12600 12600 12600 12600 SVC009219 BONE DENSITOMETRY SINGLE FEMUR 1260 1890 1890 1890 1890 1890 SVC009220 BONE DENSITOMETRY SINGLE FEMUR WITH FRACTURE RISK ESTIMATE 1260 1890 1890 1890 1890 1890 SVC009221 BONE DENSITOMETRY LUMBAR SPINE AP 1260 1890 1890 1890 1890 1890 SVC009222 BONE DENSITOMETRY LUMBAR SPINE AP & FEMUR 2870 4300 4300 4300 4300 4300 SVC009223 BONE DENSITOMETRY WHOLE BODY FAT FRACTION 4350 6530 6530 6530 6530 6530 SVC009227 CT CONTRAST TOPUP PACKAGE 4130 4130 4130 4130 4130 4130 SVC009229 CT PERIPHERAL VENOGRAM 10500 15750 15750 15750 15750 15750 SVC009231 MRI AORTAGRAM-CONTRAST 16500 16500 16500 16500 16500 16500 SVC009234 MRI CARDIAC 10500 15750 15750 15750 15750 15750 SVC009235 MRI CARDIAC WITH CONTRAST 13650 20480 20480 20480 20480 20480 SVC009236 MRI CARDIAC STRESS 16800 25200 25200 25200 25200 25200 SVC009238 CT GUIDED NERVE BLOCK 7350 11030 11030 11030 11030 11030 SVC009239 MRI FISTULOGRAM 7350 11030 11030 11030 11030 11030 SVC009240 MRI KUB 8820 13230 13230 13230 13230 13230 SVC009241 CT GUIDED CATHETER DRAINAGE 7350 11030 11030 11030 11030 11030 SVC009243 XRAY THORACO LUMBAR SPINE AP & LAT 560 840 840 840 840 840 SVC009245 MRI GUIDED NEURO NAVIGATION WITH CONTRAST STUDY 6300 6300 6300 6300 6300 6300 SVC009246 CT GUIDED NEURO NAVIGATION PLAIN STUDY 3150 4730 4730 4730 4730 4730 SVC009247 CT GUIDED NEURO NAVIGATION WITH CONTRAST STUDY 5250 5250 5250 5250 5250 5250 SVC009248 CT LS SPINE WITH CONTRAST 6300 9450 9450 9450 9450 9450 SVC009249 PERIPHERAL ARTERY AMBULATION 12600 18900 18900 18900 18900 18900 SVC009250 MRI VENOGRAM CONTRAST 10500 15750 15750 15750 15750 15750 SVC009251 USG GUIDED FNAC 5250 7880 7880 7880 7880 7880 SVC009252 FIBROSCAN OF LIVER 5000 5000 6500 7500 8500 9500 SVC009254 PERCUTANEOUS SCLEROTHERPY 16500 21500 24800 28100 31400 SVC009255 MRI RT. THIGH 7350 11030 11030 11030 11030 11030 SVC009260 CT GUIDED ABSCESS DRAINAGE 7700 7700 10100 11600 13100 14700 SVC009266 GLUE INJECTION (PERIPHERAL AVM) 11060 16580 16580 16580 16580 16580 SVC009268 MRI FACE 7500 11250 11250 11250 11250 11250 SVC009269 MRI ACUTE CEREBRAL STROKE LIMITED STUDY 11550 11550 11550 11550 11550 11550 SVC009270 MRI BRAIN WITH MR SPECTROSCOPY 16500 16500 16500 16500 16500 16500 SVC009272 X RAY DCG 3630 3630 3630 3630 3630 3630 SVC009276 USG GUIDED PSOAS ABSCESS ASPIRATION 6300 9450 9450 9450 9450 9450 SVC009290 EMERGENCY ULTRASOUND 3780 3780 3780 3780 3780 3780 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC009291 XRAY ANKLE MORTISE VIEW 370 560 560 560 560 560 SVC009292 MRI ASSESSMENT OF LIVER AND CARDIAC IRON 4200 6300 6300 6300 6300 6300 SVC009293 CT GUIDED BONE BIOPSY 8400 12600 12600 12600 12600 12600 SVC009295 XRAY SPINE AP & LAT VIEW 670 1010 1010 1010 1010 1010 SVC009299 USG GUIDED PIGTAIL CATHETER DRAINAGE OF PSEUDOCYSTS 7560 11340 11340 11340 11340 11340 SVC009300 MRI FERRI-SCAN 5250 7880 7880 7880 7880 7880 SVC009302 CT HIGH RISK CONTRAST (VISIPAQUE 270MG ) 50ML 1260 1260 1260 1260 1260 1260 SVC009303 CT HIGH RISK CONTRAST (VISIPAQUE 270MG ) 100ML 2520 2520 2520 2520 2520 2520 SVC009317 KIDNEY BIOPSY NEW GUN- INTERVENTIONAL RADIOLOGY 9190 13780 13780 13780 13780 13780 SVC009320 MRI TRIPLE PHASE LIVER 12600 18900 18900 18900 18900 18900 SVC009321 DENTAL XRAY 150 220 220 220 220 220 SVC009322 XRAY RIGHT THUMB OBLIQUE VIEW 370 550 550 550 550 550 SVC009323 XRAY THORACIC SPINE AP 370 550 550 550 550 550 SVC009325 MRI LUMBOSACRAL PLEXUS 8820 13230 13230 13230 13230 13230 SVC009326 MRI LUMBOSACRAL PLEXUS WITH CONTRAST 11550 17330 17330 17330 17330 17330 SVC009334 CT ANGIOGRAPHY CORONARY 128 SLICE 13460 20190 20190 20190 20190 20190 SVC009336 CT ANGIOGRAPHY CORONARY 128 SLICE + PULMONARY + AORTA 16800 25200 25200 25200 25200 25200 SVC009338 MRI EPILEPSY PROTOCOL 8400 12600 12600 12600 12600 12600 SVC009372 XRAY SINGLE THUMB OBLIQUE VIEW 370 550 550 550 550 550 SVC009387 CT BRONCHOSCOPY 8250 8250 8250 8250 8250 8250 SVC009390 CT DENTAL - MANDIBLE 6600 6600 6600 6600 6600 6600 SVC009391 CT DENTAL - MAXILLA 6600 6600 6600 6600 6600 6600 SVC009424 XRAY BOTH KNEE JOINT AP&LAT 1290 1290 1290 1290 1290 1290 SVC009426 XRAY CHEST LATERAL 580 580 580 580 580 580 SVC009427 XRAY CHEST-AP 460 690 690 690 690 690 SVC009434 XRAY T M JOINT 580 580 580 580 580 580 SVC009436 VIDEO FLUOROSCOPY SWALLOW STUDY (VFSS) 3890 5830 5830 5830 5830 5830 SVC009546 MRI FUNCTIONAL BOLD 3T 8400 12600 12600 12600 12600 12600 SVC009589 MRI ENTEROGRAPHY CONTRAST 3T 10500 15750 15750 15750 15750 15750 SVC009594 MRI DEFAECOGRAPHY 3T 8820 13230 13230 13230 13230 13230 SVC009628 MRI SIALOGRAM 7350 11030 11030 11030 11030 11030 SVC009632 USG LIVER ELASTOGRAPHY 2100 3150 3150 3150 3150 3150 SVC009639 XRAY HANDS BOTH LAT 670 1010 1010 1010 1010 1010 SVC009649 CT REVIEW CHARGES 1050 1580 1580 1580 1580 1580 SVC009650 MRI REVIEW CHARGES 1260 1890 1890 1890 1890 1890 SVC009655 USG KUB + PVR 1680 2520 2520 2520 2520 2520 SVC009657 CARDIAC COMPUTED TOMOGRAPHY FOR CALCIUM SCORING (IMAGING) 2100 3150 3150 3150 3150 3150 SVC009674 USG BIOPSY-COMPLEX 8400 12600 12600 12600 12600 12600 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC009675 USG GUIDANCE FOR DIAGNOSTIC PROCEDURE 3150 4730 4730 4730 4730 4730 SVC009676 GUIDANCE FOR DIAGNOSTIC PROCEDURE-BEDSIDE 5250 7880 7880 7880 7880 7880 SVC009677 USG GUIDANCE FOR THERAPEUTIC PROCEDURE 4200 6300 6300 6300 6300 6300 SVC009678 USG GUIDANCE FOR THERAPEUTIC PROCEDURE-BEDSIDE 6300 9450 9450 9450 9450 9450 SVC009679 MRI PROSTATE-MP/SPECTRO 8500 12750 12750 12750 12750 12750 SVC009680 ER NCCT ABDOMEN/KUB 3150 3150 3150 3150 3150 3150 SVC009690 X-RAY REPORTING 110 170 170 170 170 170 SVC009691 USG FAST(FOCUSED ASSESSMENT WITH SONOGRAPHY IN TRAUMA) 1580 2360 2360 2360 2360 2360 SVC009692 USG GUIDANCE 4000 5200 6000 6800 7600 SVC009694 CT PLAIN POST PROCEDURE COLLECTION 3150 4730 4730 4730 4730 4730 SVC009695 CT SINOGRAM 5040 7560 7560 7560 7560 7560 SVC009696 CT ENTEROGRAPHY 8400 12600 12600 12600 12600 12600 SVC009697 MRI FAT ESTIMATION 3150 4730 4730 4730 4730 4730 SVC009698 MRI ARTHROGRAPHY-SINGLE JOINT 10500 15750 15750 15750 15750 15750 SVC009699 MRI CISTERNOGRAPHY WITH CONTRAST 10500 15750 15750 15750 15750 15750 SVC009700 MRI DIFFUSION SINGLE SEQUENCE 2520 3780 3780 3780 3780 3780 SVC009701 CT 3D RECONSTRUCTION 1580 2360 2360 2360 2360 2360 SVC009726 CT RAPID MODULE-SERVICE CHARGES 14700 22050 22050 22050 22050 22050 SVC009727 MRI RAPID MODULE-SERVICE CHARGES 14700 22050 22050 22050 22050 22050 SVC009755 MRI HAND LEFT 7350 11030 11030 11030 11030 11030 SVC009756 MRI FOREARM LEFT WITH CONTRAST 10500 15750 15750 15750 15750 15750 SVC009758 MRI FOOT LEFT 7350 11030 11030 11030 11030 11030 SVC009759 MRI FEMUR LEFT WITH CONTRAST 10500 15750 15750 15750 15750 15750 SVC009760 MRI FEMUR LEFT 7350 7350 7350 7350 7350 7350 SVC009761 CT HUMERUS LEFT 4200 6300 6300 6300 6300 6300 SVC009765 CT FEMUR LEFT PLAIN 4200 6300 6300 6300 6300 6300 SVC009777 USG EARLY PREGNANCY (12W) - TWINS 158550 158550 158550 158550 158550 158550 SVC009781 USG FETAL DOPPLER - TWINS 148500 148500 148500 148500 148500 148500 SVC009783 USG PREGNANCY - TWINS 154000 154000 154000 154000 154000 154000 SVC009785 USG PREGNANCY + DOPPLER & BPP - TWINS 166100 166100 166100 166100 166100 166100 SVC009787 USG FOETAL WELL BEING (ANAMOLY SCAN) - TWINS 173800 173800 173800 173800 173800 173800 SVC011430 CT LIVER VOLUMETRY 2100 2100 2100 2100 2100 2100 SVC011826 CT DBS PROTOCOL 3150 3150 3150 3150 3150 3150 SVC011827 CT DBS PROTOCOL WITH CONTRAST 5250 5250 5250 5250 5250 5250 SVC011828 DOPPLER HEPATIC (LTP) 3150 4730 4730 4730 4730 4730 SVC011829 GUIDED NERVE BLOCK 6300 9450 9450 9450 9450 9450 SVC011831 MRI DBS PROTOCOL 7350 7350 7350 7350 7350 7350 SVC011832 MRI DBS PROTOCOL WITH CONTRAST 10500 10500 10500 10500 10500 10500 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC011840 USG_ GROIN DOPPLER 4950 4950 4950 4950 4950 4950 SVC011842 XRAY HKA VIEW 800 1200 1200 1200 1200 1200 SVC011843 XRAY SHOULDER ONE Y VIEW 370 560 560 560 560 560 SVC011844 XRAY WHOLE SPINE SCANOGRAM 800 1200 1200 1200 1200 1200 SVC011929 DVD CHARGES 400 400 400 400 400 400 SVC011930 CT DVD CHARGES 350 350 350 350 350 350 SVC011931 XRAY DVD CHARGES 260 260 260 260 260 260 SVC011932 USG DVD CHARGES 320 320 320 320 320 320 SVC012878 MRI SHOULDER BOTH JOINTS 8250 8250 8250 8250 8250 8250 PKG016393 CT TRAUMA PROTOCOL 12600 16380 18900 21420 23940 SVC012909 PRE OP CT CHEST 4400 4400 4400 4400 4400 4400 Radiotherapy PKG021215 RE SRS PACKAGE 181500 235950 272250 308550 344850 PKG021216 SBRT LUNG 3-5# PACKAGE 330000 429000 495000 561000 627000 PKG021217 SBRT LUNG 6-10# PACKAGE 385000 500500 577500 654500 731500 PKG021218 SBRT MULTIPLE SITES PACKAGE 308000 400400 462000 523600 585200 PKG021219 SBRT PALLIATIVE PACKAGE 137500 178750 206250 233750 261250 PKG021220 SBRT SPINE 1# PACKAGE 203500 264550 305250 345950 386650 PKG021221 SBRT SPINE 3# PACKAGE 220000 286000 330000 374000 418000 PKG021222 SRS COMPLEX PACKAGE 241500 313950 362250 410550 458850 PKG021223 SRS PALL/BOOST SIMPLE PACKAGE 184800 240240 277200 314160 351120 PKG021224 SRS SIMPLE PACKAGE 220000 286000 330000 374000 418000 SVC009769 SRS SIMPLE- (PLANNING ) 154000 154000 154000 154000 154000 154000 SVC009771 SRS COMPLEX- (PLANNING ) 152250 152250 152250 152250 152250 152250 SVC009772 SRS PALL/BOOST SIMPLE- (PLANNING ) 87150 87150 87150 87150 87150 87150 SVC009773 SRS PALL/BOOST COMPLEX- (PLANNING ) 89250 89250 89250 89250 89250 89250 SVC009774 RE SRS- (PLANNING ) 136500 136500 136500 136500 136500 136500 SVC009775 SRT- (PLANNING ) 154000 154000 154000 154000 154000 154000 SVC009779 USG NT SCAN - TWINS 165900 165900 165900 165900 165900 165900 SVC009789 USG FIBROSCAN 158550 158550 158550 158550 158550 158550 SVC009791 DOTATATE PET CT SCAN 165900 165900 165900 165900 165900 165900 SVC009793 SBRT MULTIPLE SITES- (PLANNING ) 158550 158550 158550 158550 158550 158550 SVC009794 SBRT PALLIATIVE- (PLANNING ) 89250 89250 89250 89250 89250 89250 SVC009795 ICRT PER FRACTION- (PLANNING ) 12810 12810 12810 12810 12810 12810 SVC009796 ICRT IMPLANT- (PLANNING ) 12810 12810 12810 12810 12810 12810 SVC009797 OVOIDS- (PLANNING ) 4410 4410 4410 4410 4410 4410 SVC009798 SORBO PER FRACTION- (PLANNING ) 7560 7560 7560 7560 7560 7560 SVC009799 MUPIT- (PLANNING ) 11760 11760 11760 11760 11760 11760 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC009800 ISRT RADICAL HN- (PLANNING ) 43260 43260 43260 43260 43260 43260 SVC009801 ISRT RADICAL HN BOOST- (PLANNING ) 22260 22260 22260 22260 22260 22260 SVC009802 ISRT BREAST (APBI)- (PLANNING ) 43260 43260 43260 43260 43260 43260 SVC009803 ISRT BOOST- (PLANNING ) 6510 6510 6510 6510 6510 6510 SVC009804 INTRA-OP (SARCOMA)- (PLANNING ) 6510 6510 6510 6510 6510 6510 SVC009805 ILRT BRON/ESO/NPX- (PLANNING ) 4410 4410 4410 4410 4410 4410 SVC009806 SURFACE MOLD RADICAL- (PLANNING ) 1260 1260 1260 1260 1260 1260 SVC009807 SURFACE MOLD BOOST- (PLANNING ) 1260 1260 1260 1260 1260 1260 SVC009808 ANAL BRACHY- (PLANNING ) 4410 4410 4410 4410 4410 4410 SVC009809 PROSTATE BRACHY- (PLANNING ) 6510 6510 6510 6510 6510 6510 SVC009810 PROSTATE SEED- (PLANNING ) 5250 5250 5250 5250 5250 5250 SVC009811 PALLIATIVE SINGLE WITHOUT SIM- (PLANNING ) 8400 8400 8400 8400 8400 8400 SVC009812 PALLIATIVE SINGLE WITH SIMULATION - (PLANNING ) 10500 10500 10500 10500 10500 10500 SVC009813 PALLIATIVE MULTIPLE - (PLANNING ) 10500 10500 10500 10500 10500 10500 SVC009814 MULTIPLE SITES ON 1 DAY- (PLANNING ) 10500 10500 10500 10500 10500 10500 SVC009815 MULTIPLE SITES FRACTIONATED- (PLANNING ) 21000 21000 21000 21000 21000 21000 SVC009816 PALLIATIVE SHORT COURSE IMRT- (PLANNING ) 49880 49880 49880 49880 49880 49880 SVC009817 CONVENTIONAL- (PLANNING ) 27300 27300 27300 27300 27300 27300 SVC009818 ADJUVANT RT- (PLANNING ) 27300 27300 27300 27300 27300 27300 SVC009819 RADICAL RT- (PLANNING ) 27300 27300 27300 27300 27300 27300 SVC009820 3DCRT- (PLANNING ) 30980 30980 30980 30980 30980 30980 SVC009821 IMRT 15 (PLANNING ) 63470 63470 63470 63470 63470 63470 SVC009822 IMRT 30 (PLANNING ) 66360 66360 66360 66360 66360 66360 SVC009823 IMRT31-40 (PLANNING ) 69520 69520 69520 69520 69520 69520 SVC009824 IMRT>40 (PLANNING ) 72270 72270 72270 72270 72270 72270 SVC009825 IMRT WITH 4D GATING- (PLANNING ) 80850 80850 80850 80850 80850 80850 SVC009826 IMRT WITH DIBH- (PLANNING ) 80850 80850 80850 80850 80850 80850 SVC009827 ABC- (PLANNING ) 80850 80850 80850 80850 80850 80850 SVC009828 EXTENDED IMRT- (PLANNING ) 80850 80850 80850 80850 80850 80850 SVC009829 ADAPTIVE IMRT- (PLANNING ) 80850 80850 80850 80850 80850 80850 SVC009830 PET BASED IMRT- (PLANNING ) 75600 75600 75600 75600 75600 75600 SVC009831 PET BASED IMRT WITH 4D GATING- (PLANNING ) 80850 80850 80850 80850 80850 80850 SVC009832 PET BASED IMRT ADAPTIVE- (PLANNING ) 80850 80850 80850 80850 80850 80850 SVC009833 IMRT BOOST- (PLANNING ) 26250 26250 26250 26250 26250 26250 SVC009834 RAPID ARC IMRT- (PLANNING ) 68990 68990 68990 68990 68990 68990 SVC009835 CSI- (PLANNING ) 80850 80850 80850 80850 80850 80850 SVC009836 EXTRACORPOREAL RADIATION- (PLANNING ) 10500 10500 10500 10500 10500 10500 SVC009837 TBI- (PLANNING ) 47250 47250 47250 47250 47250 47250 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC009838 HEMIBODY RADIATION - (PLANNING ) 47250 47250 47250 47250 47250 47250 SVC009839 IGRT 15 (PLANNING ) 63470 63470 63470 63470 63470 63470 SVC009840 IGRT 30 (PLANNING ) 69520 69520 69520 69520 69520 69520 SVC009841 IGRT 31-40 (PLANNING ) 69520 69520 69520 69520 69520 69520 SVC009842 IGRT >40 (PLANNING ) 72270 72270 72270 72270 72270 72270 SVC009843 IGRT WITH 4D GATING- (PLANNING ) 80850 80850 80850 80850 80850 80850 SVC009844 IGRT WITH DIBH- (PLANNING ) 80850 80850 80850 80850 80850 80850 SVC009845 IGRT WITH ABC- (PLANNING ) 80850 80850 80850 80850 80850 80850 SVC009846 EXTENDED IGRT- (PLANNING ) 80850 80850 80850 80850 80850 80850 SVC009847 ADAPTIVE IGRT- (PLANNING ) 80850 80850 80850 80850 80850 80850 SVC009848 RAPID ARC IGRT WITH 4D GATING- (PLANNING ) 80850 80850 80850 80850 80850 80850 SVC009849 RAPID ARC IGRT- (PLANNING ) 68990 68990 68990 68990 68990 68990 SVC009850 ELECTRON RADICAL - (PLANNING ) 30450 30450 30450 30450 30450 30450 SVC009851 3 CLAMP PEDIATRIC HEAD 4200 4200 4200 4200 4200 4200 SVC009852 3 CLAMP HEAD HYBRID 4200 4200 4200 4200 4200 4200 SVC009853 3 CLAMP CAST (HEAD) 4200 4200 4200 4200 4200 4200 SVC009854 4 CLAMP HEAD AND NECK 4200 4200 4200 4200 4200 4200 SVC009855 5 CLAMP (HEAD AND NECK) 4200 4200 4200 4200 4200 4200 SVC009856 4 CLAMP (THORAX) 4200 4200 4200 4200 4200 4200 SVC009857 4 CLAMP (ABDOMEN) 4200 4200 4200 4200 4200 4200 SVC009858 6 CLAMP 4200 4200 4200 4200 4200 4200 SVC009859 6 CLAMP (NTA) 4200 4200 4200 4200 4200 4200 SVC009860 MRI RT PLANNING 12600 12600 12600 12600 12600 12600 SVC009861 CT RT PLANNING PLAIN 6300 6300 6300 6300 6300 6300 SVC009862 CT RT PLANNING TRIPPLE PHASE 10500 10500 10500 10500 10500 10500 SVC009863 CT RT PLANNING WITH CONTRAST 8400 8400 8400 8400 8400 8400 SVC009864 4D CT PLANNING 12600 12600 12600 12600 12600 12600 SVC009865 SRS SIMPLE- (DELIVERY ) 63000 63000 63000 63000 63000 63000 SVC009866 SRS COMPLEX- (DELIVERY ) 89250 89250 89250 89250 89250 89250 SVC009867 SRS PALL/BOOST SIMPLE- (DELIVERY ) 21000 21000 21000 21000 21000 21000 SVC009868 SRS PALL/BOOST COMPLEX- (DELIVERY ) 42000 42000 42000 42000 42000 42000 SVC009869 RE SRS- (DELIVERY ) 36750 36750 36750 36750 36750 36750 SVC009870 SRT- (DELIVERY ) 94500 94500 94500 94500 94500 94500 SVC009871 FSRS 3-5 SIMPLE- (DELIVERY ) 141900 141900 141900 141900 141900 141900 SVC009872 FSRS 3-5 COMPLEX- (DELIVERY ) 183700 183700 183700 183700 183700 183700 SVC009873 SBRT SPINE 1 (DELIVERY ) 55000 55000 55000 55000 55000 55000 SVC009874 SBRT SPINE 3 (DELIVERY ) 66000 66000 66000 66000 66000 66000 SVC009875 SBRT LUNG 3-5 (DELIVERY ) 163900 163900 163900 163900 163900 163900 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC009876 SBRT LUNG 6-10 (DELIVERY ) 211200 211200 211200 211200 211200 211200 SVC009877 SBRT LIVER 3-5 (DELIVERY ) 163900 163900 163900 163900 163900 163900 SVC009878 SBRT LIVER 6-10 (DELIVERY ) 211200 211200 211200 211200 211200 211200 SVC009879 SBRT MULTIPLE SITES- (DELIVERY ) 135450 135450 135450 135450 135450 135450 SVC009880 SBRT PALLIATIVE- (DELIVERY ) 42000 42000 42000 42000 42000 42000 SVC009881 ICRT PER FRACTION- (DELIVERY ) 10290 10290 10290 10290 10290 10290 SVC009882 ICRT IMPLANT- (DELIVERY ) 18690 18690 18690 18690 18690 18690 SVC009883 OVOIDS- (DELIVERY ) 15020 15020 15020 15020 15020 15020 SVC009884 SORBO PER FRACTION- (DELIVERY ) 8190 8190 8190 8190 8190 8190 SVC009885 MUPIT- (DELIVERY ) 77490 77490 77490 77490 77490 77490 SVC009886 ISRT RADICAL HN- (DELIVERY ) 45990 45990 45990 45990 45990 45990 SVC009887 ISRT RADICAL HN BOOST- (DELIVERY ) 22260 22260 22260 22260 22260 22260 SVC009888 ISRT BREAST (APBI)- (DELIVERY ) 30240 30240 30240 30240 30240 30240 SVC009889 ISRT BOOST- (DELIVERY ) 35490 35490 35490 35490 35490 35490 SVC009890 INTRA-OP (SARCOMA)- (DELIVERY ) 6510 6510 6510 6510 6510 6510 SVC009891 ILRT BRON/ESO/NPX- (DELIVERY ) 10290 10290 10290 10290 10290 10290 SVC009892 SURFACE MOLD RADICAL- (DELIVERY ) 77490 77490 77490 77490 77490 77490 SVC009893 SURFACE MOLD BOOST- (DELIVERY ) 56490 56490 56490 56490 56490 56490 SVC009894 ANAL BRACHY- (DELIVERY ) 48090 48090 48090 48090 48090 48090 SVC009895 PROSTATE BRACHY- (DELIVERY ) 35490 35490 35490 35490 35490 35490 SVC009896 PROSTATE SEED- (DELIVERY ) 47250 47250 47250 47250 47250 47250 SVC009897 PALLIATIVE SINGLE WITHOUT SIM- (DELIVERY ) 12600 12600 12600 12600 12600 12600 SVC009898 PALLIATIVE SINGLE WITH SIMULATION - (DELIVERY ) 26250 26250 26250 26250 26250 26250 SVC009899 PALLIATIVE MULTIPLE - (DELIVERY ) 47250 47250 47250 47250 47250 47250 SVC009900 MULTIPLE SITES ON 1 DAY- (DELIVERY ) 21000 21000 21000 21000 21000 21000 SVC009901 MULTIPLE SITES FRACTIONATED- (DELIVERY ) 31500 31500 31500 31500 31500 31500 SVC009902 PALLIATIVE SHORT COURSE IMRT- (DELIVERY ) 49880 49880 49880 49880 49880 49880 SVC009903 CONVENTIONAL- (DELIVERY ) 56700 56700 56700 56700 56700 56700 SVC009904 ADJUVANT RT- (DELIVERY ) 61950 61950 61950 61950 61950 61950 SVC009905 RADICAL RT- (DELIVERY ) 67200 67200 67200 67200 67200 67200 SVC009906 3DCRT- (DELIVERY ) 95030 95030 95030 95030 95030 95030 SVC009907 IMRT 15 (DELIVERY ) 93830 93830 93830 93830 93830 93830 SVC009908 IMRT 30 (DELIVERY ) 133140 133140 133140 133140 133140 133140 SVC009909 IMRT31-40 (DELIVERY ) 161480 161480 161480 161480 161480 161480 SVC009910 IMRT>40 (DELIVERY ) 169730 169730 169730 169730 169730 169730 SVC009911 IMRT WITH 4D GATING- (DELIVERY ) 234150 234150 234150 234150 234150 234150 SVC009912 IMRT WITH DIBH- (DELIVERY ) 234150 234150 234150 234150 234150 234150 SVC009913 ABC- (DELIVERY ) 234150 234150 234150 234150 234150 234150 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC009914 EXTENDED IMRT- (DELIVERY ) 255150 255150 255150 255150 255150 255150 SVC009915 ADAPTIVE IMRT- (DELIVERY ) 181650 181650 181650 181650 181650 181650 SVC009916 PET BASED IMRT- (DELIVERY ) 123900 123900 123900 123900 123900 123900 SVC009917 PET BASED IMRT WITH 4D GATING- (DELIVERY ) 155400 155400 155400 155400 155400 155400 SVC009918 PET BASED IMRT ADAPTIVE- (DELIVERY ) 155400 155400 155400 155400 155400 155400 SVC009919 IMRT BOOST- (DELIVERY ) 31500 31500 31500 31500 31500 31500 SVC009920 RAPID ARC IMRT- (DELIVERY ) 141020 141020 141020 141020 141020 141020 SVC009921 CSI- (DELIVERY ) 150150 150150 150150 150150 150150 150150 SVC009922 EXTRACORPOREAL RADIATION- (DELIVERY ) 31500 31500 31500 31500 31500 31500 SVC009923 TBI- (DELIVERY ) 42000 42000 42000 42000 42000 42000 SVC009924 HEMIBODY RADIATION - (DELIVERY ) 26250 26250 26250 26250 26250 26250 SVC009925 IGRT 15 (DELIVERY ) 134530 134530 134530 134530 134530 134530 SVC009926 IGRT 30 (DELIVERY ) 221980 221980 221980 221980 221980 221980 SVC009927 IGRT 31-40 (DELIVERY ) 249480 249480 249480 249480 249480 249480 SVC009928 IGRT >40 (DELIVERY ) 279730 279730 279730 279730 279730 279730 SVC009929 IGRT WITH 4D GATING- (DELIVERY ) 255150 255150 255150 255150 255150 255150 SVC009930 IGRT WITH DIBH- (DELIVERY ) 255150 255150 255150 255150 255150 255150 SVC009931 IGRT WITH ABC- (DELIVERY ) 255150 255150 255150 255150 255150 255150 SVC009932 EXTENDED IGRT- (DELIVERY ) 265650 265650 265650 265650 265650 265650 SVC009933 ADAPTIVE IGRT- (DELIVERY ) 192150 192150 192150 192150 192150 192150 SVC009934 RAPID ARC IGRT WITH 4D GATING- (DELIVERY ) 255150 255150 255150 255150 255150 255150 SVC009935 RAPID ARC IGRT- (DELIVERY ) 225020 225020 225020 225020 225020 225020 SVC009936 ELECTRON RADICAL - (DELIVERY ) 100800 100800 100800 100800 100800 100800 SVC009954 FREEZING 57900 57900 75300 86900 98500 110100 SVC009955 FROZEN EMBYO TRANSFER 50800 50800 66100 76200 86400 96600 SVC012889 FSRS 3-5# SIMPLE- (PLANNING ) 166100 166100 166100 166100 166100 166100 SVC012890 FSRS 3-5# SIMPLE PACKAGE 308000 308000 308000 308000 308000 308000 Spine Surgery SVC010599 CERVICAL LAMINECTOMY / POSTERIOR FUSION SINGLE 58740 76360 88110 99860 111610 SVC010602 KYPHOPLASTY 26950 35040 40430 45820 51210 SVC010603 LUMBAR DISCECTOMY 23760 30890 35640 40390 45140 SVC010605 NERVE ROOT BLOCK 5150 6690 7720 8750 9780 SVC010606 ODONTOID SCREW FIXATION 39600 51480 59400 67320 75240 SVC010607 SCOLIOSIS SURGERY - ANTERIOR RELEASE (MAJOR) 60500 78650 90750 102850 114950 SVC010608 SCOLIOSIS SURGERY - ANTERIOR RELEASE (MINOR) 60500 78650 90750 102850 114950 SVC010609 SCOLIOSIS SURGERY - POST INSTRUMENTATION (MAJOR) 60500 78650 90750 102850 114950 SVC010610 SCOLIOSIS SURGERY - POST INSTRUMENTATION (MINOR) 60500 78650 90750 102850 114950 SVC010613 TOTAL DISC REPLACEMENT CERVICAL (MULTIPLE LEVEL) 60500 78650 90750 102850 114950 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC010614 TOTAL DISC REPLACEMENT CERVICAL (SINGLE LEVEL) 52800 68640 79200 89760 100320 SVC010615 TOTAL DISC REPLACEMENT LUMBAR 42350 55060 63530 72000 80470 SVC010616 TRANSFORAMINAL LUMBAR INTERBODY FUSION 60500 78650 90750 102850 114950 SVC010617 VERTEBROPLASTY 27280 35460 40920 46380 51830 SVC010619 CERVICAL DISCECTOMY ANTERIOR WITH FUSION 44000 57200 66000 74800 83600 SVC010620 ANTERIOR INSTRUMENTATION 40920 53200 61380 69560 77750 SVC010621 COMBINED ANTERIOR AND POSTERIOR SPINAL SURGERY 82500 107250 123750 140250 156750 SVC010625 DISCECTOMY 48310 62810 72470 82130 91790 SVC010627 MINIMAL INVASIVE DISCECTOMY 38280 49760 57420 65080 72730 SVC010628 CERVICAL LAMINOPLASTY 49500 64350 74250 84150 94050 Surgical Oncology SVC006872 AXILLARY LYMPH NODE DISSECTION 32230 41900 48350 54790 61240 SVC006873 BREAST RECONSTUCTION WITH MICROVASCULAR FLAP 50820 66070 76230 86390 96560 SVC006874 CHEMO PORT INSERTION 7700 10010 11550 13090 14630 SVC006875 COLOSTOMY CLOSURE 18700 24310 28050 31790 35530 SVC006876 DILATATION & CURETTAGE 4400 5720 6600 7480 8360 SVC006877 EXAMINATION UNDER ANAESTHESIA 2200 2860 3300 3740 4180 SVC006879 FEEDING JEJUNOSTOMY 13200 17160 19800 22440 25080 SVC006880 HEMICOLECTOMY 24200 31460 36300 41140 45980 SVC006882 LAPAROSCOPIC ADRENALECTOMY 47960 62350 71940 81530 91120 SVC006883 LAPAROSCOPIC RADICAL NEPHRECTOMY 41710 54230 62570 70910 79250 SVC006884 LAPAROSCOPIC SMALL BOWEL RESECTION 42350 55060 63530 72000 80470 SVC006886 LAPAROTOMY 18040 23450 27060 30670 34280 SVC006887 SINGLE LOBECTOMY 42790 55630 64190 72740 81300 SVC006888 MEDIASTINAL TUMORS EXCISION 37070 48190 55610 63020 70430 SVC006889 MEDIASTINOSCOPY 28050 36470 42080 47690 53300 SVC006890 OPEN SPLENECTOMY 14080 18300 21120 23940 26750 SVC006891 OVARIAN CYSTECTOMY 18150 23600 27230 30860 34490 SVC006892 PANCREATICODUODENECTOMY (WHIPPLE'S RESECTION) 60980 79270 91470 103670 115860 SVC006893 PERMCATH INSERTION-ONCOLOGY 12100 15730 18150 20570 22990 SVC006894 PLEURODESIS 15290 19880 22940 25990 29050 SVC006895 PNEUMONECTOMY 47190 61350 70790 80220 89660 SVC006897 SIMPLE MASTECTOMY 20020 26030 30030 34030 38040 SVC006898 SIMPLE VULVECTOMY 24530 31890 36800 41700 46610 SVC006901 THYMECTOMY 53240 69210 79860 90510 101160 SVC006902 OPEN RADICAL NEPHRECTOMY 33000 42900 49500 56100 62700 SVC006906 CHEMO PORT INSERTION GA 5500 7150 8250 9350 10450 SVC006909 OPEN RADICAL NEPHRECTOMY (COMPLEX) 42350 55060 63530 72000 80470 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC006910 BUCCAL MUCOSA COMPOSITE RESECTION/COMMANDO 32230 41900 48350 54790 61240 SVC006912 MANDIBULECTOMY SEGMENTAL 22000 28600 33000 37400 41800 SVC006913 RECONSTRUCT. WITH INTERPOL. COMPOSITE FLAP 32230 41900 48350 54790 61240 SVC006914 FREE FIBULA FOR MANDIBULAR RECONSTRUCTION 44000 57200 66000 74800 83600 SVC006915 BUCCAL MUCOSA WIDE EXCISION 24200 31460 36300 41140 45980 SVC006916 MODIFIED NECK DISSECTION 28600 37180 42900 48620 54340 SVC006917 RECONSTRUCT WITH FLAP - CHEST AND ABDOMINAL WALL 40260 52340 60390 68440 76490 SVC006918 COLORECTAL ANASTOMOSIS 30580 39750 45870 51990 58100 SVC006919 RECONSTRUCTION WITH ANATOMICAL CLOSURE 24200 31460 36300 41140 45980 SVC006920 ALVEOLECTOMY ( UPPER) PER ORAL 21780 28310 32670 37030 41380 SVC006921 ALVEOLECTOMY (BOTH JAWS) 6050 7870 9080 10290 11500 SVC006922 ALVEOLECTOMY (ONE JAWS) 3190 4150 4790 5420 6060 SVC006923 TONGUE COMPOSITE RESECTION/ COMMANDO 45980 59770 68970 78170 87360 SVC006924 ALVEOLUS COMPOSITE RESECTION/ COMMANDO 45980 59770 68970 78170 87360 SVC006925 PHARYNGECTOMY PARTIAL 36300 47190 54450 61710 68970 SVC006926 CENTRAL COMPARTMENT CLEARANCE 36300 47190 54450 61710 68970 SVC006927 NECK EXPLORATION 21780 28310 32670 37030 41380 SVC006928 FLAP DIVISION AND INSETTING 36300 47190 54450 61710 68970 SVC006938 MAXILLECTOMY PARTIAL 27500 35750 41250 46750 52250 SVC006948 SMALL BOWEL RESECTION ANASTOMOSIS 44000 57200 66000 74800 83600 SVC012013 Infratemporal fossa clearance 22000 28600 33000 37400 41800 SVC012030 Abdominal Mass Excision 19800 25740 29700 33660 37620 SVC012040 Hepatic Metastatectomy 22000 28600 33000 37400 41800 SVC012214 EUA + BIOPSY 3850 5010 5780 6550 7320 SVC012215 MICROLARYNGOSCOPY 8800 11440 13200 14960 16720 SVC012216 BILATERAL MODIFIED NECK DISSECTION 44000 57200 66000 74800 83600 SVC012217 SALVAGE NECK DISSECTION 28600 37180 42900 48620 54340 SVC012218 SALVAGE LARYNGECTOMY 27500 35750 41250 46750 52250 SVC012219 FLAP DEVISION 5500 7150 8250 9350 10450 SVC012220 EXTERNAL CAROTID ARTERY LIGATION 16500 21450 24750 28050 31350 SVC012221 SALVAGE ORAL CANCER RESECTION 27500 35750 41250 46750 52250 Urology PKG003330 DJ STENT REMOVAL PKG 9200 11950 13790 15630 17470 PKG004599 CYSTOSCOPY PKG 14040 18250 21050 23860 26670 PKG004639 PERCUTANEOUS NEPHROLITHOTOMY (PCNL) PKG 91630 119120 137450 155770 174100 PKG004701 TRANSURETHRAL RESECTION OF PROSTATE (TURP) PKG 87120 113260 130680 148100 165530 PKG007728 BILATERAL ORCHIDECTOMY PKG 49500 64350 74250 84150 94050 PKG007824 MEATOTOMY-PKG 9900 12870 14850 16830 18810 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC010681 BILATERAL ORCHIDECTOMY 17600 22880 26400 29920 33440 SVC010682 BILATERAL ORCHIDOPEXY 27390 35610 41090 46560 52040 SVC010684 BLADDER WASHOUT 4570 5930 6850 7760 8670 SVC010685 BLADDER NECK INCISION 19800 25740 29700 33660 37620 SVC010686 BLADDER NECK SUSPENSION 35860 46620 53790 60960 68130 SVC010687 CYSTOSCOPY 7850 10210 11780 13350 14920 SVC010688 PENILE STRAIGHTENING 18150 23600 27230 30860 34490 SVC010689 CIRCUMCISION 11000 14300 16500 18700 20900 SVC010690 VESICO VAGINAL FISTULA REPAIR/ URETERO VAGINA FISTULA REPAIR 29150 37900 43730 49560 55390 SVC010695 CYSTOSCOPY_02 9240 12010 13860 15710 17560 SVC010698 DIVERTICULECTOMY 20130 26170 30200 34220 38250 SVC010700 DORSAL SLIT 5780 7510 8660 9820 10970 SVC010701 DRAIN/CATHETER PLACEMENT 5890 7650 8830 10000 11180 SVC010702 ENDOSCOPIC URETEROCOELE INCISION 22000 28600 33000 37400 41800 SVC010703 EPIDIDYMECTOMY UNILATERAL 8910 11580 13370 15150 16930 SVC010707 FLEXIBLE CYSTOSCOPY 6820 8870 10230 11590 12960 SVC010708 FRENULOPLASTY 8800 11440 13200 14960 16720 SVC010709 HYDROCOELE REPAIR UNILATERAL 10450 13590 15680 17770 19860 SVC010710 ILEAL CONDUIT DIVERSION 40260 52340 60390 68440 76490 SVC010714 LAPAROSCOPIC BIOPSY 15180 19730 22770 25810 28840 SVC010715 LAPAROSCOPIC PYELOPLASTY 46200 60060 69300 78540 87780 SVC010716 LAPAROSCOPIC URETEROLITHOTOMY 38500 50050 57750 65450 73150 SVC010717 LAPAROSCOPIC VARICOCOELECTOMY 31680 41180 47520 53860 60190 SVC010718 MEATOPLASTY 14300 18590 21450 24310 27170 SVC010719 CYSTOLITHOTOMY 16060 20880 24090 27300 30510 SVC010720 CYSTOSTOMY (OPEN) 12430 16160 18650 21130 23620 SVC010722 PARTIAL NEPHRECTOMY (OPEN) 47300 61490 70950 80410 89870 SVC010723 PROSTATECTOMY (OPEN) 28820 37470 43230 48990 54760 SVC010724 PARTIAL CYSTECTOMY 26400 34320 39600 44880 50160 SVC010725 PARTIAL PENECTOMY 22000 28600 33000 37400 41800 SVC010726 PELVIC EXENTERATION 59730 77650 89600 101540 113490 SVC010727 REPAIR OF PENILE FRACTURE 24200 31460 36300 41140 45980 SVC010728 PCNL (STAGHORN) 44770 58200 67160 76110 85060 SVC010729 ANASTOMOTIC URETHROPLASTY 31240 40610 46860 53110 59360 SVC010731 PYELOLITHOTOMY (OPEN) 22220 28890 33330 37770 42220 SVC010732 PYELOPLASTY (OPEN) 29150 37900 43730 49560 55390 SVC010733 RADICAL CYSTECTOMY AND ILEAL CONDUIT 56980 74070 85470 96870 108260 SVC010735 RADICAL PROSTATECTOMY 47300 61490 70950 80410 89870 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC010736 LAPAROSCOPIC RADICAL PROSTATECTOMY 62480 81220 93720 106220 118710 SVC010739 ANTEGRADE/RETROGRADE URETHROGRAM 2860 3720 4290 4860 5430 SVC010740 RETROPERITONEAL LYMPH NODE DISSECTION (< 5 CM MASS) 35750 46480 53630 60780 67930 SVC010743 SUBCAPSULAR ORCHIDECTOMY 17600 22880 26400 29920 33440 SVC010744 SUBSTITUTION URETHROPLASTY (NOT FULL LENGTH) 49170 63920 73760 83590 93420 SVC010745 HYPOSPADIAS REPAIR 24200 31460 36300 41140 45980 SVC010746 TESTICULAR BIOPSY 6270 8150 9410 10660 11910 SVC010747 TOTAL PENECTOMY 23210 30170 34820 39460 44100 SVC010748 TRANSPUBIC URETHROPLASTY 44770 58200 67160 76110 85060 SVC010749 TRANSRECTAL PROSTATE BIOPSY 5540 7210 8320 9420 10530 SVC010751 TUBE EXCHANGE 570 740 860 970 1090 SVC010753 URETERIC REIMPLANTATION 37400 48620 56100 63580 71060 SVC010755 URETEROLITHOTOMY (OPEN) 21890 28460 32840 37210 41590 SVC010759 URETHRAL DILATATION 7920 10300 11880 13460 15050 SVC010760 MEATOTOMY 3800 4930 5690 6450 7210 SVC010761 URETEROURETEROSTOMY 38500 50050 57750 65450 73150 SVC010762 URETHROPLASTY 27060 35180 40590 46000 51410 SVC010764 URODYNAMICS 7230 9400 10850 12290 13740 SVC010765 UROFLOWMETRY 1140 1480 1710 1940 2170 SVC010766 VARICOCOELECTOMY (OPEN) 13640 17730 20460 23190 25920 SVC010767 VASECTOMY 8150 10600 12230 13860 15490 SVC010768 VESICOSTOMY 11880 15440 17820 20200 22570 SVC010769 VESICOSTOMY CLOSURE 9080 11800 13610 15430 17240 SVC010770 WEDGE BIOPSY 3030 3930 4540 5140 5750 SVC010772 TRANSURETHRAL RESECTION OF PROSTATE < 40 GM 37840 49190 56760 64330 71900 SVC010776 NEPHROLITHOTOMY 31240 40610 46860 53110 59360 SVC010778 AV FISTULA 13200 17160 19800 22440 25080 SVC010780 CYSTOLITHOTRIPSY + TURP 33000 42900 49500 56100 62700 SVC010781 CYSTOSCOPY AND BLADDER BIOPSY 19800 25740 29700 33660 37620 SVC010784 PERINEPHRIC ABSCESS DRAINAGE (OPEN) 16280 21160 24420 27680 30930 SVC010786 EXTENDED PYELOLITHOTOMY 49170 63920 73760 83590 93420 SVC010787 GRAFT NEPHRECTOMY 62590 81370 93890 106400 118920 SVC010790 ILEAL REPLACEMENT OF URETER 47520 61780 71280 80780 90290 SVC010791 LAPAROSCOPIC PARTIAL NEPHRECTOMY 55000 71500 82500 93500 104500 SVC010792 PELVIC LYMPH NODE DISSECTION 23980 31170 35970 40770 45560 SVC010794 PERCUSTANEOUS NEPHROSTOMY 13600 17670 20390 23110 25830 SVC010796 TRANS OBTURATOR/ TRANS VAGINAL TAPE INSERTION 44000 57200 66000 74800 83600 SVC010797 RETROGRADE INTRARENAL SURGERY (RIRS) 27280 35460 40920 46380 51830 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC010798 TOTAL PENECTOMY AND URETHROSTOMY 37400 48620 56100 63580 71060 SVC010801 URETEROSCOPIC STONE REMOVAL 26400 34320 39600 44880 50160 SVC010803 MICROSCOPIC VASOVASOSTOMY/ VASO EPIDIDYMOSTOMY 49170 63920 73760 83590 93420 SVC010806 SPC INSERTION 8250 10730 12380 14030 15680 SVC010807 CALIBRATION 970 1260 1450 1650 1840 SVC010810 URETHRAL STRICTURE REPAIR 11000 14300 16500 18700 20900 SVC010812 INTRAVESICAL BCG THERAPY 2200 2860 3300 3740 4180 SVC010816 NEPHROSTOGRAM 1710 2220 2560 2900 3240 SVC010825 RADICAL CYSTECTOMY 63580 82650 95370 108090 120800 SVC010826 RENAL AUTOTRANSPLANTATION 93500 121550 140250 158950 177650 SVC010831 AUGMENTATION CYSTOPLASTY 66000 85800 99000 112200 125400 SVC010838 URS 19800 25740 29700 33660 37620 SVC010839 BUCCAL URETHEROPLASTY 53680 69780 80520 91260 101990 SVC010840 LASER TURP LESS THAN 50 GMS 38500 50050 57750 65450 73150 SVC010841 LASER TURP MORE THAN 50 GMS 60500 78650 90750 102850 114950 SVC010842 LASER BNI (BLADDER NECK INCISION) 22440 29170 33660 38150 42640 SVC010845 LASER PUV FULGURATION 27500 35750 41250 46750 52250 SVC010846 LASER ENDOPYELOTOMY 31240 40610 46860 53110 59360 SVC010849 TRANSURETHRAL RESECTION OF PROSTATE (TURP) MORE THAN 50 GMS 44000 57200 66000 74800 83600 SVC010850 OIU (CORE THROUGH) 7920 10300 11880 13460 15050 SVC010851 TRANSURETHRAL RESECTION OF BLADDER TUMOUR (TURBT) - TUMOR MORE THAN 2 CMS37400 48620 56100 63580 71060 SVC010852 ENDOSCOPIC CYSTOLITHOTRIPSY - STONE MORE THAN 2 CMS 13640 17730 20460 23190 25920 SVC010855 NEPHROSTOMY 19690 25600 29540 33470 37410 SVC010859 ORCHIDOPEXY 19690 25600 29540 33470 37410 SVC010866 HYDROCOELE REPAIR BILATERAL 18700 24310 28050 31790 35530 SVC010881 LAPAROSCOPIC URETERIC RE IMPLANTATION 41580 54050 62370 70690 79000 SVC010883 LAPAROSCOPIC NEPHROURETERCTOMY 93500 121550 140250 158950 177650 SVC010886 RADICAL CYSTECTOMY AND NEOBLADDER FORMATION 85800 111540 128700 145860 163020 SVC010887 RADICAL NEPHRECTOMY WITH IVC EXPLORATION 49500 64350 74250 84150 94050 SVC010895 LASER TRANSURETHRAL RESECTION OF PROSTATE (LASER-TURP) 42020 54630 63030 71430 79840 SVC010897 DJ STENTING B/L 18150 23600 27230 30860 34490 SVC010898 RETROGRADE INTRARENAL SURGERY ( RIRS ) - BILATERAL 38610 50190 57920 65640 73360 SVC010899 MICROSURGICAL INGUINAL VARICOCELECTOMY - UNILATERAL 26400 34320 39600 44880 50160 SVC010900 MICROSURGICAL INGUINAL VARICOCELECTOMY - BILATERAL 33330 43330 50000 56660 63330 SVC010902 DJ STENT REMOVAL - BILATERAL 10780 14010 16170 18330 20480 SVC010906 LITHOTRIPSY 32270 41960 48410 54870 61320 SVC010911 URETERIC CATHETERIZATION 2420 3150 3630 4110 4600 SVC010912 URETHROSTOMY PERINEAL 25410 33030 38120 43200 48280 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC010913 URS B/L 31350 40760 47030 53300 59570 SVC010915 URETEROCALICOSTOMY 44000 57200 66000 74800 83600 SVC010916 CHECK CYSTOSCOPY LA 3850 5010 5780 6550 7320 SVC010918 CHECK CYSTOSCOPY GA 2860 3720 4290 4860 5430 SVC010919 NEPHROURETERECTOMY,RADICAL WITH BLADDER CUFF EXCISION, OPEN 71500 92950 107250 121550 135850 SVC010928 CHORDEE CORRECTION 14300 18590 21450 24310 27170 SVC010929 OPEN SIMPLE NEPHRECTOMY 38500 50050 57750 65450 73150 SVC010930 LAPAROSCOPIC SIMPLE NEPHRECTOMY 76560 99530 114840 130150 145460 SVC010932 DJ STENTING UNILATERAL 13600 17670 20390 23110 25830 SVC010935 SUBSTITUTION URETHROPLASTY (FULL LENGTH) 60500 78650 90750 102850 114950 SVC010936 SUBSTITUTION URETHROPLASTY (STAGE 1) 28380 36890 42570 48250 53920 SVC010937 SUBSTITUTION URETHROPLASTY (STAGE 2) 38500 50050 57750 65450 73150 SVC010938 PENILE IMPLANTATION 38500 50050 57750 65450 73150 SVC010939 RADICAL ORCHIDECTOMY 27500 35750 41250 46750 52250 SVC010940 TURBT TUMOR LESS THAN 2CMS 20900 27170 31350 35530 39710 SVC010941 INTRAVESICAL BOTOX 6820 8870 10230 11590 12960 SVC010942 ILIO INGUINAL LYMPH NODE DISSECTION-U/L 24420 31750 36630 41510 46400 SVC010943 ILIO INGUINAL LYMPH NODE DISSECTION-B/L 34650 45050 51980 58910 65840 SVC010944 OIU 18340 23840 27510 31170 34840 SVC010945 CLP/PCCL (ENDOSCOPIC CYSTOLITHOTRIPSY) STONE MORE THAN 2CMS 24420 31750 36630 41510 46400 SVC010946 CLP/PCCL (ENDOSCOPIC CYSTOLITHOTRIPSY) STONE LESS THAN 2CMS 17600 22880 26400 29920 33440 SVC010947 PREPUTIAL SEPARATION 1710 2220 2560 2900 3240 SVC010949 RADICAL NEPHRECTOMY+LEVEL 2 THROMBUS IVC 60500 78650 90750 102850 114950 SVC010950 RADICAL NEPHRECTOMY+LEVEL 3 THROMBUS IVC 82500 107250 123750 140250 156750 SVC010951 LAP VVF REPAIR 55000 71500 82500 93500 104500 SVC010952 LAP URETEROLYSIS -U/L 44000 57200 66000 74800 83600 SVC010953 HOLEP-LARGE 77000 100100 115500 130900 146300 SVC010954 PCNL PARTIAL STAG HORN 36300 47190 54450 61710 68970 SVC010955 TRANURETHRAL RESECTION IN SALINE 60500 78650 90750 102850 114950 SVC010956 SCROTAL DEBRIDEMENT U/L 27500 35750 41250 46750 52250 SVC010957 PRIAPISM DECOMPRESSION 8800 11440 13200 14960 16720 SVC010958 ADRENALECTOMY-B/L 71500 92950 107250 121550 135850 SVC010959 LAPAROSCOPIC ADRENALECTOMY-SIMPLE-B/L 82500 107250 123750 140250 156750 SVC010960 LAP VAULT PROLAPSE SURGERY 66000 85800 99000 112200 125400 SVC010961 RETROPERITONEAL MASS EXCSION-MEDIUM 38500 50050 57750 65450 73150 SVC010962 RETROPERITONEAL MASS EXCSION-LARGE 60500 78650 90750 102850 114950 SVC010963 RIRS-COMPLEX 55000 71500 82500 93500 104500 SVC010964 PEYRONIE'S PLAQUE EXCISION+ GRAFTING 27500 35750 41250 46750 52250 Service_Code Service_Name OPD General Semi Private Private Suite Deluxe Suite SVC010965 CYSTOSCOPY + RGP 15400 20020 23100 26180 29260 SVC010966 CLOT EVACUATION 12100 15730 18150 20570 22990 SVC010967 ANASTOMOTIC URETHEROPLASTY WITH INFERIOR PUBECTOMY 60500 78650 90750 102850 114950 SVC011054 SCROTAL EXPLORATION 25300 32890 37950 43010 48070 SVC011059 CYSTO FULGURATION 22000 28600 33000 37400 41800 SVC012995 TESTIS IMPLANT 15000 19500 22500 25500 28500 SVC013141 URETIC DIALATATION 10000 13000 15000 17000 19000 Vascular Surgery PKG003111 AV FISTULA PKG 19800 25740 29700 33660 37620 PKG004782 CAROTID STENTING (EM) PKG 115500 150150 173250 196350 219450 SVC011061 PERMCATH INSERTION 8800 11440 13200 14960 16720 SVC011075 AORTIC STENTING 60500 78650 90750 102850 114950 SVC011076 CAROTID STENTING 59510 77360 89270 101170 113070 SVC011082 FEMORO-POPLITEAL BYPASS ABOVE KNEE 8800 11440 13200 14960 16720 SVC011091 THROMBOLYSIS (ARTERIAL OR VENOUS) 38500 50050 57750 65450 73150 SVC011096 RADIO-CEPHALIC FISTULA 13750 17880 20630 23380 26130 SVC011107 ENDOVENOUS LASER TREATMENT OF VARICOSE VEINS UNILATERAL 26400 34320 39600 44880 50160 SVC011108 OPEN SURGERY FOR VARICOSE VEINS 16500 21450 24750 28050 31350 SVC011110 INJECTION SCLEROTHERAPY OF VARICOSE VEINS WITH US SCAN 11000 14300 16500 18700 20900 SVC011113 IVC FILTER PLACEMENT 22000 28600 33000 37400 41800 SVC011116 TIPSS 55000 71500 82500 93500 104500 SVC011124 PERMACATH/ PORTACATH PLACEMENT 28930 37610 43400 49180 54970 SVC011125 PERMACATH/ PORTACATH REMOVAL 4510 5860 6770 7670 8570 SVC011127 BELOW KNEE AMPUTATION 20020 26030 30030 34030 38040 SVC011128 ABOVE KNEE AMPUTATION 20020 26030 30030 34030 38040 SVC011130 TOE AMPUTATION 7980 10370 11960 13560 15150 SVC011132 MINOR DEBRIDEMENT 3580 4650 5360 6080 6790 SVC011137 CAROTID BODY TUMOUR 30030 39040 45050 51050 57060 SVC011138 HICKMANS CATHETER INSERTION 11000 14300 16500 18700 20900 SVC011140 PERIPHERAL ANGIOPLASTY 22000 28600 33000 37400 41800 SVC011146 EMBOLECTOMY - FEMORAL 22000 28600 33000 37400 41800 SVC011154 PTA (PERIPHERAL ANGIOPLASTY) 39600 51480 59400 67320 75240 SVC011163 BELOW ELBOW AMPUTATION - U/L 8250 10730 12380 14030 15680